Mental Hygiene Services Rates
- Rates also available in Portable Document Format (PDF)
OPWDD Rate Codes as of 5/1/25
| Rate Code | Definition | OPWDD Purpose | State/Voluntary |
|---|---|---|---|
| 1096 | MA CVRD NON-MEDICARE CVRD-DUALS-ART 16-DTC-APG | Effective 7/1/21 | Voluntary |
| 1098 | MA CVRD NON-COMM INS CVRD-ART 16-DTC-APG | Effective 7/1/21 | Voluntary |
| 1546 | OPWDD APG - Free-Standing Article 16 Clinic | On-Site - Effective 7/1/11 | |
| 1605 | OPWDD Specialty Hospital; Vol Operated; Per Diem | Effective 1/1/13 | Voluntary |
| 1900 | OPWDD CARE COORD ORG/HH LVL 1; VOL; MTHLY | Effective 7/1/18 | Voluntary |
| 1901 | OPWDD CARE COORD ORG/HH LVL 2; VOL; MTHLY | Effective 7/1/18 | Voluntary |
| 1902 | OPWDD CARE COORD ORG/HH LVL 3; VOL; MTHLY | Effective 7/1/18 | Voluntary |
| 1903 | OPWDD CARE COORD ORG/HH LVL 4; VOL; MTHLY | Effective 7/1/18 | Voluntary |
| 1904 | OPWDD CARE COORD ORG/HH OPT OUT; VOL; MTHLY | Effective 7/1/18 | Voluntary |
| 1905 | OPWDD CARE COORD ORG/HH TRANS; MTHLY | Effective 7/1/18 | Voluntary |
| 1906 | OPWDD CARE COORD ORG/HH OPT OUT TRNS; MTHLY | Effective 7/1/18 | Voluntary |
| 2438 | OPWDD FIDA - Age 21-49 Medicare Dual | Effective 4/1/16 | Voluntary |
| 2439 | OPWDD FIDA - Age 50+ Medicare Dual | Effective 4/1/16 | Voluntary |
| 3167 | VEHICLE ADAPT; $1 PER UNIT FEE;OPWDD | Effective 4/1/24 | State |
| 3168 | VEHICLE ADAPT; $10 PER UNIT FEE;OPWDD | Effective 4/1/24 | State |
| 3169 | VEHICLE ADAPT; $100 PER UNIT FEE;OPWDD | Effective 4/1/24 | State |
| 3170 | VEHICLE ADAPT; $1000 PER UNIT FEE;OPWDD | Effective 4/1/24 | State |
| 3822 | HRF/MR | VOICF | Voluntary |
| 4100 | State Operated OPWDD Development Center | State | |
| 4101 | OPWDD State Operated ICF/DD | State | |
| 4102 | OPWDD St. Op ICFDD Small Residential Unit | State | |
| 4104 | ICF; Vol; Day Service; Full Unit | VOICF Day Service - Effective 1/1/15 | Voluntary |
| 4105 | ICF; Vol; Day Service; Half Unit | VOICF Day Service - Effective 1/1/15 | Voluntary |
| 4106 | ICF; Vol; Vocational Service; Full Unit | VOICF Prevoc Service - Effective 1/1/15 | Voluntary |
| 4107 | ICF; Vol; Vocational Service; Half Unit | VOICF Prevoc Service - Effective 1/1/15 | Voluntary |
| 4108 | ICF; Vol; INHS Day Service; Full Unit | VOICF In House Day Service effective 1/1/16 | Voluntary |
| 4109 | ICF; Vol;Comm Voc; Group 3 + Ind | Effective 7/1/15 | Voluntary |
| 4110 | ICF; State; Day Service; Full Unit | SOICF Day Service - Effective 4/1/16 | State |
| 4111 | ICF; State; Day Service; Half Unit | SOICF Day Service - Effective 4/1/16 | State |
| 4112 | ICF; State; Vocational Service; Full Unit | SOICF Prevoc Service - Effective date TBD | State |
| 4113 | ICF; State; Vocational Service; Half Unit | SOICF Prevoc Service - Effective date TBD | State |
| 4114 | ICF; State; INHS Day Service; Full Unit | SOICF In House Day Service - effective date TBD | State |
| 4115 | ICF; State; Comm Voc; Group 3 + Ind | Effective TBD | State |
| 4116 | ICF; Vol; Comm Vocational 1:1 | Effective 7/1/15 | Voluntary |
| 4117 | ICF; Vol;Comm Voc; Group of 2 | Effective 7/1/15 | Voluntary |
| 4118 | ICF; State; Comm; Vocational 1:1 | Effective TBD | State |
| 4119 | ICF; State; Comm Voc; Group of 2 | Effective TBD | State |
| 4120 | ICF TEMPLATE SPECIALIZED; VOL; PER DIEM | Effective 9/1/18 | Voluntary |
| 4121 | ICF TEMPLATE HIGHLY COMPLEX; VOL;PER DIEM | Effective 9/1/18 | Voluntary |
| 4122 | ICF AUSPICE CHANGE; VOL; PER DIEM | Effective 9/1/18 | Voluntary |
| 4170 | OPWDD Day Treatment Full Day | Voluntary | |
| 4171 | OPWDD Day Treatment Half Day | Voluntary | |
| 4428 | Res Hab; State-IRA Supvd; Per Diem | Effective 7/1/14 | State |
| 4429 | Res Hab; State-IRA Supvd; Med Leave; Per Diem | Effective 7/1/14 | State |
| 4430 | Res Hab; State-IRA Supvd; Non-Med Leave; Per Diem | Effective 7/1/14 | State |
| 4431 | Res Hab; State-FC; Per Diem | Effective 7/1/15 | State |
| 4433 | Path to Employment; State; Indiv; 1/4 Hr | Effective 7/1/14 | State |
| 4434 | Path to Employment; State; Group; 1/4 Hr | Effective 7/1/14 | State |
| 4436 | Prevoc; Community; State; 1/4 Hr | Effective 7/1/15 | State |
| 4437 | Res Hab; Vol-IRA Supvd; Per Diem | Effective 7/1/14 | Voluntary |
| 4438 | Res Hab; Vol-IRA Supvd; Med Leave; Per Diem | Effective 7/1/14 | Voluntary |
| 4439 | Res Hab; Vol-IRA Supvd; Non-Med Leave; Per Diem | Effective 7/1/14 | Voluntary |
| 4440 | Res Hab; Voluntary-FC; Per Diem | Voluntary | |
| 4444 | Path to Employment; Vol; Indiv; 1/4 Hr | Effective 7/1/14 | Voluntary |
| 4445 | Path to Employment; Vol; Group; 1/4 Hr | Effective 7/1/14 | Voluntary |
| 4446 | Grp Day Hab-State;Full Unit/OPWDD | State | |
| 4447 | Grp Day Hab-State;Half Unit/OPWDD | State | |
| 4450 | SEMP; Intensive; State; Ind; 1/4 Hr | Effective 7/1/15 | State |
| 4451 | SEMP; Intensive; State; Grp; 1/4 Hr | Effective 7/1/15 | State |
| 4453 | Grp Day Hab-Vol;Full Unit/OPWDD | Voluntary | |
| 4454 | Grp Day Hab-Vol;Half Unit/OPWDD | Voluntary | |
| 4455 | Supplemental Grp Day Hab-Vol Full Unit/OPWDD | Voluntary | |
| 4456 | Supplemental Grp Day Hab-Vol Half Unit/OPWDD | Voluntary | |
| 4458 | Prevoc-State;Full Unit/OPWDD | State | |
| 4459 | Prevoc-State;Half Unit/OPWDD | State | |
| 4460 | SEMP; Extended; State; Ind; 1/4 Hr | Effective 7/1/15 | State |
| 4461 | SEMP; Extended; State; Grp; 1/4 Hr | Effective 7/1/15 | State |
| 4464 | Prevoc;Voluntary;Full Unit/OPWDD | Voluntary | |
| 4465 | Prevoc;Voluntary;Half Unit/OPWDD | Voluntary | |
| 4476 | Environ Mods; $1.00 Per Unit Fee; State | State | |
| 4477 | Environ Mods; $10.00 Per Unit Fee; State | State | |
| 4478 | Environ Mods; $100.00 Per Unit Fee; State | State | |
| 4479 | Environ Mods; $1000.00 Per Unit Fee; State | State | |
| 4482 | Adaptive Technology; $1.00 Per Unit Fee; State | State | |
| 4483 | Adaptive Technology; $10.00 Per Unit Fee; State | State | |
| 4484 | Adaptive Technology; $100.00 Per Unit Fee; State | State | |
| 4485 | Adaptive Technology; $1000.00 Per Unit Fee; State | State | |
| 4496 | Individual Family Education &Training Serv-State;Unit | State | |
| 4497 | Individual Family Education &Training Serv-Voluntary;Unit | Voluntary | |
| 4498 | Group Family Education &Training Serv-State;Unit | State | |
| 4499 | Group Family Education &Training Serv-Voluntary;Unit | Voluntary | |
| 4703 | Res Hab;State;IRA-Suprt Monthly | State | |
| 4704 | Res Hab;State;IRA-Suprt Semi-Monthly 1st half | State | |
| 4705 | Res Hab;State;IRA-Suprt Semi-Monthly 2nd half | State | |
| 4709 | Res Hab;Vol;IRA/CR-Suprt Monthly | Voluntary | |
| 4710 | Res Hab;Vol;IRA/CR-Suprt Semi-Monthly 1st half | Voluntary | |
| 4711 | Res Hab;Vol;IRA/CR-Suprt Semi-Monthly 2nd half | Voluntary | |
| 4720 | IBS; Vol; IBP/FBA Plan Development; Flat Fee | Effective 10/1/13 | Voluntary |
| 4721 | IBS; Vol; Plan Implementation; ¼ Hr | Effective 10/1/13 | Voluntary |
| 4722 | Comm/Res Hab; Vol; Indiv; ¼ Hr | Effective 11/1/10 | Voluntary |
| 4723 | Comm/Res Hab; Vol; Group – 2 Individuals; ¼ Hr | Effective 11/1/10 | Voluntary |
| 4724 | Comm/Res Hab; Vol; Group – 3 Individuals; ¼ Hr | Effective 11/1/10 | Voluntary |
| 4741 | Comm/Res Hab; State; Group-1 Individual; 1/4 Hr | Effective 10/1/13 | State |
| 4742 | Comm/Res Hab; State; Group-2 Individuals; 1/4 Hr | Effective 10/1/13 | State |
| 4743 | Comm/Res Hab; State; Group-3 Individuals; 1/4 Hr | Effective 10/1/13 | State |
| 4749 | Respite-Hourly;1/4 Hour Unit; State | VO OPTS and SO Effective 2/1/10 | State |
| 4755 | Com Hab; Agy Sup; Vol; Ind; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4756 | Com Hab; Agy Sup; Vol; Grp; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4757 | Com Hab; Cert Fac Resid; Agy Sup; Vol; Ind; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4758 | Com Hab; Cert Fac Resid; Agy Sup; Vol; Grp; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4759 | SEMP; Agy Sup; Phase 1; Vol; Ind; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4760 | SEMP; Agy Sup; Phase 1; Vol; Grp; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4761 | SEMP; Agy Sup; Phase 2; Vol; Ind; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4762 | SEMP; Agy Sup; Phase 2; Vol; Grp; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4764 | Respite; Via FI Fee; Vol; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4765 | Com Hab; Via FI; Vol; Ind; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4766 | Com Hab; Via FI; Vol; Grp; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4767 | Com Hab; Cert Fac Resid; Via FI; Vol; Ind; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4768 | Com Hab; Cert Fac Resid; Via FI; Vol; Grp; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4769 | SEMP; Via FI; Phase 1; Vol; Ind; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4770 | SEMP; Via FI; Phase 1; Vol; Grp; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4771 | SEMP; Via FI; Phase 2; Vol; Ind; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4772 | SEMP; Via FI; Phase 2; Vol; Grp; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4777 | Live-In Caregiver; Via FI; Vol; Month | Effective 10/1/14 | Voluntary |
| 4778 | Support Broker; Via FI; Vol; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4781 | Prevoc; Comm; Ind; Vol; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4782 | Prevoc; Comm; Group of 2; Vol; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4783 | Prevoc; Comm; Group of 3+; Vol; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4785 | Ind Goods & Svcs; Via FI; Vol; $10 Unit | Effective 10/1/14 | Voluntary |
| 4786 | Com Trans Svcs; Via FI; Vol; $10 Unit | Effective 12/1/14 | Voluntary |
| 4787 | Fiscal Intermediary; Vol; Level 1; Mth | Effective 10/1/14 | Voluntary |
| 4788 | Fiscal Intermediary; Vol; Level 2; Mth | Effective 10/1/14 | Voluntary |
| 4789 | Fiscal Intermediary; Vol; Level 3; Mth | Effective 10/1/14 | Voluntary |
| 4790 | SEMP; Intensive; Vol; Ind; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4791 | SEMP; Intensive; Vol; Grp; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4792 | SEMP; Extended; Vol; Ind; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4793 | SEMP; Extended; Vol; Grp; 1/4 Hr | Effective 7/1/15 | Voluntary |
| 4796 | Com Hab; Cert Fac Resid; Vol; Ind; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4797 | Com Hab; Cert Fac Resid; Vol; Grp; 1/4 Hr | Effective 10/1/14 | Voluntary |
| 4798 | Com Hab; Cert Fac Resid; State; Ind; 1/4 Hr | Effective 11/1/17 | State |
| 4799 | Com Hab; Cert Fac Resid; State; Grp; 1/4 Hr | Effective 11/1/17 | State |
| 7400 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 1 | Effective 7/1/17 | Voluntary |
| 7401 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 1;MED LEAVE | Effective 7/1/17 | Voluntary |
| 7402 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 1;NONMED LEAVE | Effective 7/1/17 | Voluntary |
| 7403 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 2 | Effective 7/1/17 | Voluntary |
| 7404 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 2;MED LEAVE | Effective 7/1/17 | Voluntary |
| 7405 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 2;NONMED LEAVE | Effective 7/1/17 | Voluntary |
| 7406 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 3 | Effective 7/1/17 | Voluntary |
| 7407 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 3;MED LEAVE | Effective 7/1/17 | Voluntary |
| 7408 | RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 3;NONMED LEAVE | Effective 7/1/17 | Voluntary |
| 7409 | RES HAB; VOL; IRA SPT MTH; HIGH NEEDS TIER 1 | Effective 7/1/17 | Voluntary |
| 7410 | RES HAB; VOL; IRA SPT 1ST; HIGH NEEDS TIER 1 | Effective 7/1/17 | Voluntary |
| 7411 | RES HAB; VOL; IRA SPT 2ND; HIGH NEEDS TIER 1 | Effective 7/1/17 | Voluntary |
| 7412 | RES HAB; VOL; IRA SPT MTH; HIGH NEEDS TIER 2 | Effective 7/1/17 | Voluntary |
| 7413 | RES HAB; VOL; IRA SPT 1ST; HIGH NEEDS TIER 2 | Effective 7/1/17 | Voluntary |
| 7414 | RES HAB; VOL; IRA SPT 2ND; HIGH NEEDS TIER 2 | Effective 7/1/17 | Voluntary |
| 7421 | Respite; In Home; Vol; 1/4 Hr | Effective 7/1/17 | Voluntary |
| 7422 | Respite; Site Based; Vol; 1/4 Hr | Effective 7/1/17 | Voluntary |
| 7423 | Respite; Recreation; Vol; 1/4 Hr | Effective 7/1/17 | Voluntary |
| 7424 | Respite; Camp; Vol; 1/4 Hr | Effective 7/1/17 | Voluntary |
| 7425 | Respite; Intensive; Vol; 1/4 Hr | Effective 7/1/17 | Voluntary |
| 7426 | Respite; Agy Sup; In Home; Vol; 1/4 Hr | Effective 7/1/17 | Voluntary |
| 7427 | Respite; Agy Sup Intensive; In Home; Vol; 1/4 Hr | Effective 7/1/17 | Voluntary |
| 7428 | Respite; In Home; Vol; Per Diem | Effective 7/1/17 | Voluntary |
| 7429 | Respite; Site Based; Vol; Per Diem | Effective 7/1/17 | Voluntary |
| 7430 | Respite; In Home; State; 1/4 Hr | Effective 7/1/17 | State |
| 7435 | Group Day Hab; Vol; Full Unit; High Needs Tier 1 | Effective 7/1/17 | Voluntary |
| 7436 | Group Day Hab; Vol; Half Unit; High Needs Tier 1 | Effective 7/1/17 | Voluntary |
| 7437 | Group Day Hab; Vol; Full Unit; High Needs Tier 2 | Effective 7/1/17 | Voluntary |
| 7438 | Group Day Hab; Vol; Half Unit; High Needs Tier 2 | Effective 7/1/17 | Voluntary |
| 7439 | Group Day Hab; Vol; Full Unit; High Needs Tier 3 | Effective 7/1/17 | Voluntary |
| 7440 | Group Day Hab; Vol; Half Unit; High Needs Tier 3 | Effective 7/1/17 | Voluntary |
| 7441 | Supplemental Grp Day Hab;Vol;Full Unit;High Needs Tier 1 | Effective 7/1/17 | Voluntary |
| 7442 | Supplemental Grp Day Hab;Vol;Half Unit;High Needs Tier 1 | Effective 7/1/17 | Voluntary |
| 7443 | Supplemental Grp Day Hab;Vol;Full Unit;High Needs Tier 2 | Effective 7/1/17 | Voluntary |
| 7444 | Supplemental Grp Day Hab;Vol;Half Unit;High Needs Tier 2 | Effective 7/1/17 | Voluntary |
| 7445 | Supplemental Grp Day Hab;Vol;Full Unit;High Needs Tier 3 | Effective 7/1/17 | Voluntary |
| 7446 | Supplemental Grp Day Hab;Vol;Half Unit;High Needs Tier 3 | Effective 7/1/17 | Voluntary |
| 7447 | RESPITE; INTENSIVE CSIDD RESOURCE CTR; VOL; 1/4 HR | Effective 1/1/24 | Voluntary |
| 7450 | CSIDD-Stable;Vol;Monthly | Effective 5/1/22 | Voluntary |
| 7451 | CSIDD-Mild;Vol;Monthly | Effective 5/1/22 | Voluntary |
| 7452 | CSIDD-Moderate;Vol;Monthly | Effective 5/1/22 | Voluntary |
| 7453 | CSIDD-Intensive;Vol;Monthly | Effective 5/1/22 | Voluntary |
| 7454 | CSIDD-Stable;State;Monthly | Effective 5/1/22 | State |
| 7455 | CSIDD-Mild;State;Monthly | Effective 5/1/22 | State |
| 7456 | CSIDD-Moderate;State;Monthly | Effective 5/1/22 | State |
| 7457 | CSIDD-Intensive;State;Monthly | Effective 5/1/22 | State |
| 7462 | HOME ENABLE SUPPORT; VOL; COMP ASSESS PLAN | Effective 5/1/25 | Voluntary |
| 7463 | HOME ENABLE SUPPORT; VOL; START UP | Effective 5/1/25 | Voluntary |
| 7464 | HOME ENABLE SUPPORT; VOL; TROUBLE SHOOTING | Effective 5/1/25 | Voluntary |
| 7465 | HOME ENABLE SUPPORT; VOL; ONGOING MGMT | Effective 5/1/25 | Voluntary |
| 7466 | HOME ENABLE SUPPORT; VOL; ACQUI COST; $1.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7467 | HOME ENABLE SUPPORT; VOL; ACQUI COST; $10.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7468 | HOME ENABLE SUPPORT; VOL; ACQUI COST; $100.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7469 | HOME ENABLE SUPPORT; VOL; ACQUI COST; $1000.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7470 | HOME ENABLE SUPPORT; VOL; MONTH SUBSC; $1.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7471 | HOME ENABLE SUPPORT; VOL; MONTH SUBSC; $10.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7472 | HOME ENABLE SUPPORT; VOL; MONTH SUBSC; $100.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7473 | HOME ENABLE SUPPORT; VOL; HACS MONTH SUBSC; $1.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7474 | HOME ENABLE SUPPORT; VOL; HACS MONTH SUBSC; $10.00 PER UNIT | Effective 5/1/25 | Voluntary |
| 7475 | HOME ENABLE SUPPORT; VOL; HACS MONTH SUBSC; $100.00 PER UNIT | Effective 5/1/25 | Voluntary |
