Children's Waiver Home and Community Based Services (HCBS) Notification of Rate Approval

• Notice also available in Portable Document Format (PDF)

To: Children's Home and Community Based Service (HCBS) Providers, and Medicaid Managed Care Plans (MMCPs) including Mainstream Managed Care and HIV Special Needs Plans (HIV-SNPs)

Date: November 24, 2025

This notice is to inform Children's Waiver HCBS providers and MMCPs that the New York State Department of Health (NYSDOH) has received approval from the Centers for Medicare and Medicaid Services (CMS) and NYS Department of Budget to implement a 2.6% Targeted Inflationary Increase (TII) for Children's HCBS rates retroactive to April 1, 2025.

Children's HCBS providers will automatically receive retroactive adjustments on Fee-for-Service (FFS) Medicaid claims already submitted/paid with dates of service on or after April 1, 2025. HCBS retro-payments will be included in providers' cycle 2517 payments, which are scheduled to be issued on December 3, 2025. MMCPs must configure their systems with the updated rates and issue retroactive payment adjustments to providers for dates of service on or after April 1, 2025, no later than 90 days from this notice.

Adjusted Children's HCBS rate schedules can be found at the following link:

• HCBS Rate Summary - (Web) - (PDF)

Any questions related to this notification can be send to 1915CR@health.ny.gov.