Family Care: Developmental Disability Center Rates for Managed Care Organizations
This page explains Family Care rates paid by managed care organizations (MCOs) for services members get at the State Centers for Individuals with Intellectual/Developmental Disabilities (DD centers). Wisconsin Department of Health Services (DHS) reviews and revisits these rates each calendar year.
MCO payment process to DD centers
The payment process for services at DD centers follows these steps:
- A Family Care member gets a service at a DD center.
- The DD center bills the MCO. They bill the full daily rate for Intensive Treatment Program and Medical Short-Term Care Unit stays for enrolled Family Care members.
- Family Care MCOs pay only the Family Care part of the daily rate to the DD Center. They submit payments to this address:
DHS Institutional Billing
PO Box 7853
Madison, WI 53707-7853 - After the DD Center gets the payment, they submit the claim for the fee-for-service part of the daily rate. This goes to the ForwardHealth interChange claims system.
- Family Care MCOs submit encounter reporting only for the amount they paid to the DD Center.
Notes:
- Family Care Partnership—MCOs pay the full daily rate to the DD center for Family Care Partnership members. No part of the charges goes to Medicaid fee-for-service.
- Extended stay surcharge—DHS may apply an extra fee to the total cost of care. This happens if the enrolled member stays at the DD center beyond the planned discharge date. The fees may go up every six months that the member stays at the DD center.
- Non-typical services surcharge—A provider can apply an extra fee for non-typical services. These are services that the member doesn’t normally need. For instance:
- Interpretive services
- One-on-one staffing
- Unusual living arrangements or medical services
Questions? Contact the Bureau of Rate Setting at DHSDMSBRS@dhs.wisconsin.gov.
2024 DD center rates for MCOs
The table shows the portion of rates that Family Care MCOs pay and what Medicaid fee for service pays.
| Short-Term Care Unit | Central Wisconsin Center (CWC) | Northern Wisconsin Center (NWC) | Southern Wisconsin Center (SWC) |
|---|---|---|---|
| MCO Portion/Family Care Rate | $1,431 | n/a | n/a |
| 10% Extended Stay Surcharge (first six months) | $1,604 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,777 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,950 | n/a | n/a |
| Non-Typical Services Surcharge | $1,681 | n/a | n/a |
| Medicaid Portion/Family Care Medicaid Rate | $303 | n/a | n/a |
| FC Partnership MCO Daily Rate | $1,734 | n/a | n/a |
| 10% Extended Stay Surcharge (first six months) | $1,907 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $2,080 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $2,253 | n/a | n/a |
| Non-Typical Services Surcharge | $1,984 | n/a | n/a |
| Intensive Treatment Program | Central Wisconsin Center (CWC) | Northern Wisconsin Center (NWC) | Southern Wisconsin Center (SWC) |
|---|---|---|---|
| MCO Portion/Family Care Rate | $1,552 | $1,552 | $1,552 |
| 10% Extended Stay Surcharge (first six months) | $1,748 | $1,748 | $1,748 |
| 10% Extended Stay Surcharge (additional six months) | $1,944 | $1,944 | $1,944 |
| 10% Extended Stay Surcharge (additional six months) | $2,140 | $2,140 | $2,140 |
| Non-Typical Services Surcharge | $1,802 | $1,802 | $1,802 |
| Medicaid Portion/Family Care Medicaid Rate | $406 | $406 | $406 |
| Full Intensive Treatment Program/Family Care Partnership Rate | $1,958 | $1,958 | $1,958 |
| 10% Extended Stay Surcharge (first six months) | $2,154 | $2,154 | $2,154 |
| 10% Extended Stay Surcharge (additional six months) | $2,350 | $2,350 | $2,350 |
| 10% Extended Stay Surcharge (additional six months) | $2,546 | $2,546 | $2,546 |
| Non-Typical Services Surcharge | $2,208 | $2,208 | $2,208 |
2023 DD center rates for MCOs
The table shows the portion of rates that Family Care MCOs pay and what Medicaid fee-for service pays.
| Short-Term Care Unit | Central Wisconsin Center (CWC) | Northern Wisconsin Center (NWC) | Southern Wisconsin Center (SWC) |
|---|---|---|---|
| MCO Portion/Family Care Rate | $1,267 | n/a | n/a |
| 10% Extended Stay Surcharge (first six months) | $1,427 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,586 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,746 | n/a | n/a |
| Non-Typical Services Surcharge | $1,517 | n/a | n/a |
| Medicaid Portion/Family Care Medicaid Rate | $328 | n/a | n/a |
| FC Partnership MCO Daily Rate | $1,595 | n/a | n/a |
| 10% Extended Stay Surcharge (first six months) | $1,755 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,914 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $2,074 | n/a | n/a |
| Non-Typical Services Surcharge | $1,845 | n/a | n/a |
| Intensive Treatment Program | Central Wisconsin Center (CWC) | Northern Wisconsin Center (NWC) | Southern Wisconsin Center (SWC) |
|---|---|---|---|
| MCO Portion/Family Care Rate | $1,449 | $1,449 | $1,449 |
| 10% Extended Stay Surcharge (first six months) | $1,634 | $1,634 | $1,634 |
| 10% Extended Stay Surcharge (additional six months) | $1,820 | $1,820 | $1,820 |
| 10% Extended Stay Surcharge (additional six months) | $2,006 | $2,006 | $2,006 |
| Non-Typical Services Surcharge | $1,699 | $1,699 | $1,699 |
| Medicaid Portion/Family Care Medicaid Rate | $408 | $408 | $408 |
| Full Intensive Treatment Program/Family Care Partnership Rate | $1,857 | $1,857 | $1,857 |
| 10% Extended Stay Surcharge (first six months) | $2,042 | $2,042 | $2,042 |
| 10% Extended Stay Surcharge (additional six months) | $2,228 | $2,228 | $2,228 |
| 10% Extended Stay Surcharge (additional six months) | $2,414 | $2,414 | $2,414 |
| Non-Typical Services Surcharge | $2,107 | $2,107 | $2,107 |
2022 DD center rates for MCOs
The table shows the portion of rates that Family Care MCOs pay and what Medicaid fee-for service pays.
| Short-Term Care Unit | Central Wisconsin Center (CWC) | Northern Wisconsin Center (NWC) | Southern Wisconsin Center (SWC) |
|---|---|---|---|
| MCO Portion/Family Care Rate | $970 | n/a | n/a |
| 10% Extended Stay Surcharge (first six months) | $1,090 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,211 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,331 | n/a | n/a |
| Non-Typical Services Surcharge | $1,220 | n/a | n/a |
| Medicaid Portion/Family Care Medicaid Rate | $234 | n/a | n/a |
| FC Partnership MCO Daily Rate | $1,204 | n/a | n/a |
| 10% Extended Stay Surcharge (first six months) | $1,324 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,445 | n/a | n/a |
| 10% Extended Stay Surcharge (additional six months) | $1,565 | n/a | n/a |
| Non-Typical Services Surcharge | $1,454 | n/a | n/a |
| Intensive Treatment Program | Central Wisconsin Center (CWC) | Northern Wisconsin Center (NWC) | Southern Wisconsin Center (SWC) |
|---|---|---|---|
| MCO Portion/Family Care Rate | $1,018 | $1,018 | $1,018 |
| 10% Extended Stay Surcharge (first six months) | $1,159 | $1,159 | $1,159 |
| 10% Extended Stay Surcharge (additional six months) | $1,300 | $1,300 | $1,300 |
| 10% Extended Stay Surcharge (additional six months) | $1,441 | $1,441 | $1,441 |
| Non-Typical Services Surcharge | $1,268 | $1,268 | $1,268 |
| Medicaid Portion/Family Care Medicaid Rate | $392 | $392 | $392 |
| Full Intensive Treatment Program/Family Care Partnership Rate | $1,410 | $1,410 | $1,410 |
| 10% Extended Stay Surcharge (first six months) | $1,551 | $1,551 | $1,551 |
| 10% Extended Stay Surcharge (additional six months) | $1,692 | $1,692 | $1,692 |
| 10% Extended Stay Surcharge (additional six months) | $1,833 | $1,833 | $1,833 |
| Non-Typical Services Surcharge | $1,660 | $1,660 | $1,660 |