CLTS Waiver Program Service Rates

Children's Long-Term Support (CLTS) Waiver Rates

• CLTS Waiver Program Rate Schedule, P-02184
• CLTS Code Crosswalk, P-02283
• Care Level Classification Guidelines, P-02273 (PDF)
• Care Level Classification Form, F-02467 (Word)
• Outlier Rate Request Guidelines, P-02274 (PDF)
• Outlier Rate Request, F-02538 (Word)
• CLTS Provider Cost-Based Outlier, F-02538A (Excel)

Waiver Amendment

The Wisconsin Department of Health Services (DHS) has amended the CLTS Waiver Program § 1915(c) waiver application that was approved by the Centers for Medicare & Medicaid Services (CMS) effective April 1, 2017, to March 31, 2022. The CLTS Waiver Program provides home and community-based services (HCBS) for children up to age 22 years with intellectual and developmental disabilities, physical disabilities, or severe emotional disturbance. This amendment meets the CMS requirement for DHS to implement a statewide uniform rate methodology for most CLTS waiver services.

About Rate Setting

CMS has directed DHS to create a uniform rate-setting methodology for most CLTS waiver services as per the HCBS 1915(c) regulations. The current practice, in which individual county waiver agencies set rates directly with providers, will no longer be allowed by CMS. DHS implemented the new rate methodology and supporting systems in July 2020.

CMS outlined the following guidelines for creating the statewide rate-setting methodology. The waiver must describe:

• The rate-setting methodology used for each waiver service.
• How the state exercises financial oversight to ensure that rates are determined and paid in accordance with a uniform methodology that ensures consistent rate structure for each specific service.
• How the state solicits public comment on rate determination methods.
• How information about payment rates is made available to waiver participants.
• Whether this rate determination method is used for determining self-directed budgets or if some other method is used and applied consistently to each waiver participant.

Services Included in Rate Setting

Services Exempt From Rate Setting