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Welcome to Paradigm's Medicaid Rate and State Profile Lookup Tool, designed to simplify the process of accessing Medicaid reimbursement rates and service details for home care agencies. This tool offers quick insights into service rates, claim filing periods, and state-specific Medicaid information. Please note that not all states offer every service, and if a section appears blank, it may mean that the service is either not listed on a publicly available fee schedule or doesn't exist in that state. Use this tool as a resource to stay informed, but be sure to verify any crucial details with your state or payer. For more information about the tool, important disclaimers, and our methodology, please see below.
For personalized rate and other Medicaid guidance, click here to learn about our Medicaid billing offering.
Disclaimer: By using this rate tool, you opt into receiving sales and marketing communications from Paradigm. The rates displayed are sourced from state portals and other third-party sources and are subject to change at any time. Users should independently verify all information before making decisions based on this tool. Paradigm assumes no responsibility for any actions taken based on the information provided.
This Medicaid Rate Lookup Tool provides a snapshot of key Medicaid service rates and requirements for home care agencies. Please note that not all states offer every service, so if a field appears blank, it may indicate that the service isn't available in that state or doesn't exist in the state's fee schedule.
Here’s what each field means:
- Claim Resubmission Period: The time frame you have to resubmit a denied claim for payment.
- Timely Filing Period: The maximum time after service delivery that claims must be submitted to avoid denial.
- Number of MCOs: The number of Managed Care Organizations operating in the state, which manage Medicaid benefits.
- Does Paradigm Support Enrollment?: Whether Paradigm assists with enrolling in the state’s Medicaid program/s.
- Personal/Attendant/Companion Care: The reimbursement rates for these home care services per hour.
- Homemaker/Chore: The rates for homemaker or chore services, typically per hour.
- Respite: The rates for respite care, allowing temporary relief for primary caregivers.
- EVV Aggregator(s): The system used to aggregate Electronic Visit Verification (EVV) data in the state. For more information about EVV, read our in-depth article here: A Guide to Electronic Visit Verification (EVV).
How We Compiled This Information
Paradigm has aggregated this data from various sources, including publicly available fee schedules, direct communication with state agencies or payers, and our extensive experience in working with Medicaid programs. While this tool provides a helpful snapshot, it should not be used as the sole source for making critical business decisions. Always verify the latest information with your state or payer for accuracy.
The tool is currently in beta, so if you encounter anything unexpected, we'd appreciate your feedback.
