Children's Long-Term Support (CLTS) Waiver Rates Now Available
- 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)
Online Forum Recordings
Statewide Rate-Setting Orientation
Statewide Rate-Setting Orientation for Financial Management Services Providers
Opportunity for Input
County Waiver Agency (CWA) Transition Guidance
- Interim Third Party Administration (TPA) Service Authorization Guide for Statewide Uniform Rates, P-02390
- CLTS Waiver Program Statewide Uniform Rate-Setting Transition Frequently Asked Questions, P-02392 (PDF)
- CLTS Program Rate-Setting Initiative Teleconference Recording
- CLTS Waiver Program Uniform Rates – Transition Guidance (PDF)
- CLTS Waiver Program Rate-Setting Initiative – County Transition Plan (Excel)
- CLTS Waiver Rate-Setting Initiative Implementation Timeline, P-02325 (PDF)
About the Rate-Setting Initiative
The federal Centers for Medicare & Medicaid Services (CMS) have directed the State of Wisconsin to create a uniform rate-setting methodology for most CLTS waiver services as per the home and community-based service (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. The DHS will implement the new rate methodology and supporting systems in January 2019.
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 Initiative
- Adult family home
- Case management
- Child care
- Community integration services
- Counseling and therapeutic services
- Daily living skills training
- Day services
- Financial management services
- Nursing services
- Supported employment
- Supportive home care
Services Exempt From Rate-Setting Initiative
- Adaptive aids
- Children's foster care
- Communication aids
- Consumer education and training
- Home modifications
- Housing counseling
- Personal emergency response systems
- Relocation services
- Specialized medical and therapeutic supplies
- Training for unpaid caregivers
Keep Me Posted
Providers: Sign up to receive email updates about the Waiver Service Rates Initiative.
All other interested parties: Sign up to receive email updates about the Waiver Service Rates Initiative.