Family Care, Partnership, and PACE Monthly MCO Capitation Rates

The following tables list monthly capitation rates for Family Care, Family Care Partnership, and PACE (Program of All-Inclusive Care for the Elderly) managed care organizations (MCOs). Family Care rates are listed by geographic service region (GSR). View monthly capitation rates from prior years.

2021 Family Care Capitation Rates

MCO Geographic Service Region Counties Development Disability Physical Disability Frail Elder Non-Nursing Home
Community Care, Inc. GSR 6: Ozaukee, Sheboygan, Walworth, Washington, Waukesha $4,283.19 $3,184.00 $3,114.93 $564.05
Community Care, Inc. GSR 8: Milwaukee $4,376.90 $2,925.38 $2,947.51 $587.56
Community Care, Inc. GSR 9: Fond du Lac, Manitowoc, Winnebago $3,445.23 $2,529.67 $2,789.81 $531.11
Community Care, Inc. GSR 10: Calumet, Outagamie, Waupaca $4,084.51 $2,906.49 $2,849.84 $517.86
Community Care, Inc. GSR 11: Kenosha, Racine $4,259.49 $2,995.17 $2,970.57 $590.03
Community Care, Inc. GSR 12: Dane $4,658.29 $3,629.71 $3,702.11 $545.16
Inclusa, Inc. GSR 1: Chippewa, Dunn, Eau Claire, Pierce, St. Croix, Taylor $4,561.55 $2,904.45 $2,911.38 $530.68
Inclusa, Inc. GSR 2: Buffalo, Clark, Jackson, La Crosse, Monroe, Pepin, Trempealeau, Vernon $3,977.35 $2,434.24 $2,700.08 $507.55
Inclusa, Inc. GSR 3: Crawford, Grant, Green, Iowa, Juneau, Lafayette, Richland, Sauk $3,829.12 $2,487.69 $2,686.46 $517.20
Inclusa, Inc. GSR 4: Florence, Forest, Langlade, Lincoln, Marathon, Oneida, Portage, Vilas, Wood $3,704.20 $2,664.45 $2,782.70 $511.87
Inclusa, Inc. GSR 5: Adams, Columbia, Dodge, Green Lake, Jefferson, Marquette, Waushara $3,874.41 $2,649.79 $2,646.41 $510.75
Inclusa, Inc. GSR 6: Ozaukee, Sheboygan, Walworth, Washington, Waukesha $4,002.92 $3,150.13 $2,945.11 $571.73
Inclusa, Inc. GSR 7: Ashland, Barron, Bayfield, Burnett, Douglas, Iron, Polk, Price, Rusk, Sawyer, Washburn $3,947.39 $2,653.45 $2,708.99 $523.18
Inclusa, Inc. GSR 9: Fond du Lac, Manitowoc, Winnebago* $3,932.09 $2,566.07 $2,795.25 $526.35
Inclusa, Inc. GSR 10: Calumet, Outagamie, Waupaca* $4,266.25 $2,892.70 $2,826.04 $519.55
Inclusa, Inc. GSR 13: Brown, Door, Kewaunee, Marinette, Menominee, Oconto, Shawano $4,555.56 $3,277.53 $2,708.00 578.32
Inclusa, Inc. GSR 14: Rock $5,031.44 $2,719.12 $3,092.87 $584.25
Lakeland Care Inc. GSR 4: Florence, Forest, Langlade, Lincoln, Marathon, Oneida, Portage, Vilas, Wood $3,557.92 $2,710.69 $2,725.56 $521.22
Lakeland Care Inc. GSR 9: Fond du Lac, Manitowoc, Winnebago $3,776.86 $2,564.20 $2,819.63 $528.79
Lakeland Care Inc. GSR 10: Calumet, Outagamie, Waupaca $3,897.37 $2,819.20 $2,796.20 $524.00
Lakeland Care Inc. GSR 13: Brown, Door, Kewaunee, Marinette, Menominee, Oconto, Shawano $4,028.87 $3,139.81 $3,082.05 $602.27
My Choice Wisconsin GSR 1: Chippewa, Dunn, Eau Claire, Pierce, St. Croix, Taylor $3,332.22 $2,636.45 $2,657.49 $497.20
My Choice Wisconsin GSR 2: Buffalo, Clark, Jackson, La Crosse, Monroe, Pepin, Trempealeau, Vernon $2,927.25 $2,109.15 $2,408.77 $506.63
My Choice Wisconsin GSR 3: Crawford, Grant, Green, Iowa, Juneau, Lafayette, Richland, Sauk $3,091.59 $2,292.36 $2,449.33 $547.34
My Choice Wisconsin GSR 5: Adams, Columbia, Dodge, Green Lake, Jefferson, Marquette, Waushara $3,927.10 $2,804.39 $2,789.45 $508.54
My Choice Wisconsin GSR 6: Ozaukee, Sheboygan, Walworth, Washington, Waukesha $4,378.91 $3,187.94 $3,156.78 $583.10
My Choice Wisconsin GSR 8: Milwaukee $4,063.94 $2,689.23 $2,805.75 $602.95
My Choice Wisconsin GSR 11: Kenosha, Racine $4,509.54 $2,576.55 $3,160.61 $589.40
My Choice Wisconsin GSR 12: Dane $4,647.40 $4,053.57 $3,778.88 $543.41
My Choice Wisconsin GSR 14: Rock $3,692.55 $3,172.34 $2,790.66 $611.66

Note: Effective January 1, 2021, Family Care capitation rates will be paid at the MCO GSR target group level.

*Effective April 1, 2021, Inclusa will begin operations in GSR 9 and GSR 10.

2021 Family Care Capitation Rate Report (PDF)

2021 Partnership and PACE Capitation Rates

MCO Geographic Service Region Developmental Disability, DE Developmental Disability, MA Physical Disability, DE Physical Disability, MA Frail Elder, DE Frail Elder, MA
Community Care Health Plan GSR 6: Ozaukee, Washington, Waukesha $3,822.92 $5,437.83 $3,059.20 $4,674.10 $3,333.26 $4,948.17
Community Care Health Plan GSR 8: Milwaukee $6,336.36 $7,946.92 $3,966.04 $5,576.59 $3,539.47 $5,150.02
Community Care Health Plan GSR 10: Calumet, Outagamie, Waupaca $5,256.89 $6,618.67 $2,832.66 $4,194.43 $3,186.51 $4,548.29
Community Care Health Plan GSR 11: Kenosha, Racine $4,132.76 $5,740.76 $2,843.36 $4,451.36 $3,322.02 $4,930.02
Community Care Health Plan PACE (Kenosha*, Milwaukee, Racine, Waukesha) $5,142.72 $8,514.75 $3,376.40 $6,748.42 $3,349.39 $6,721.41
Independent Care Health Plan GSR 3: Sauk $3,620.43 $4,683.98 $3,547.27 $4,610.81 $3,547.02 $4,610.55
Independent Care Health Plan GSR 8: Milwaukee $4,966.30 $6,489.88 $3,081.72 $4,605.31 $2,920.51 $4,444.09
Independent Care Health Plan GSR 11: Kenosha, Racine $4,967.20 $6,072.09 $2,819.16 $4,194.06 $3,428.39 $4,803.30
Independent Care Health Plan GSR 12: Dane $4,142.71 $5,993.60 $2,797.56 $4,648.45 $2,955.86 $4,806.76
My Choice Wisconsin Health Plan GSR 3: Sauk $3,606.22 $4,740.21 $3,533.05 $4,667.04 $3,532.80 $4,666.78
My Choice Wisconsin Health Plan GSR 5: Columbia, Dodge, Jefferson $4,510.58 $5,731.78 $3,056.72 $4,277.92 $3,089.99 $4,311.19
My Choice Wisconsin Health Plan GSR 6: Ozaukee, Washington, Waukesha $3,731.37 $5,374.08 $3,234.56 $4,877.26 $3,248.74 $4,891.44
My Choice Wisconsin Health Plan GSR 12: Dane $3,852.18 $5,512.99 $3,043.86 $4,704.68 $3,155.22 $4,816.03

Note: Effective January 1, 2021, Family Care Partnership-PACE capitation rates will be paid at the MCO GSR eligibility target group level.

Note: DE indicates Medicare-Medicaid dual eligibility. MA indicates Medicaid only eligibility.

*Effective date for PACE operations in Kenosha county is 8/1/2021.

2021 PACE Capitation Rate Report (PDF)

2021 Partnership Capitation Rate Report (PDF)

View monthly capitation rates from prior years

Last Revised: July 8, 2021