Medicaid Rates Increase July 1st

Effective July 1st, 2023, adult family homes Medicaid rates will be increasing. The rate change will vary depending on the classification level, AFH specialty contract, and the county of the home. All rate changes can be found on the adult family home Council website at this link: 2023-25-CBA-Upcoming-Increases.pdf (

Rate increases should take place automatically on July 1st, 2023. However, every time we experience a rate change, there are errors that occur. Please review your current rates and monitor the changes to ensure you are getting paid accurately. There are some common causes of these errors that may impact your residents.

Exceptions to the Rule (ETR):  During the rate change process, the ProviderOne system will look for a specific number of current rates and adjust them accordingly.  Since ETRs are authorized on the same service line as the base rate, the system will not know to automatically adjust the rate. Those require a manual adjustment by DSHS and are sometimes missed. If you have any residents with an ETR, the amount of the ETR should not be impacted by the rate increase. Sometimes a case manager will reduce the ETR by the same amount the rate increased. That is inappropriate and should not happen.

Community integration (CI): Community integration payments are also made on the same service line as the base daily rate. As described in the ETR section, this may cause the rate to require a manual adjustment.  

After July 1st, if you have questions about the rate, contact the resident’s case manager or reach out to us at the Council for support and clarification.

Also on July 1st, the COVID rate enhancements will be reduced to $5.58 per day.  This rate will remain until December 31st, 2023.  On January 1, 2024, the rate will decrease again to $2.79 per day. Lastly, your residents’ Personal Needs Allowance changes on July 1st. Residents will be allowed to retain $100 for their personal use.  This may impact the amount of participation they pay. 

These rate increases happen only because of the work the AFH Council does to negotiate improved contract terms for your home.  If you are not yet a member of the Council, then you are not participating in the opportunity to invest in advocacy for continued improvements to the rates and working conditions for all adult family home operators. The cost of dues is far less than the increases that providers will experience.  I hope you will join us today. Join | Adult Family Home Council