Rate Setting Information
OPWDD Fee Schedules
Listed are fee schedules for Voluntary and State Operated programs.
Waiver Budget Template
The Initial Price Budget Form, identified below as "Initial Price Budget Template for Waiver Programs," is an EXCEL spreadsheet that requests and captures necessary information for the determination of reimbursement levels for budget based Waiver programs. The associated instructions, identified below as "Completing and Submitting the Budget Template", contain descriptive information regarding the data that is requested as well as how to submit this data to OPWDD. PLEASE NOTE: EFFECTIVE NOVEMBER 1, 2010, REVISIONS HAVE BEEN MADE TO THE TEMPLATE AND INSTRUCTIONS. It is extremely important to go back to the website each time a budget is to be created. Avoid saving the template to your PC as you will miss crucial template updates and create more work and confusion for all parties using your uploaded budget.
Appeals and Price Adjustment Information
The logs listed below are MS EXCEL spreadsheet files that provide the current status of requests for adjustments to ICF/DD rates and Community Residence and transportation contingency requests, and Waiver price adjustments respectively. Each file has 2 sheets, the first being a description of the various status and other codes used in the logs and the second sheet reporting the Status Log content. Individual requests are identified by the identifier provided to each agency in their respective acknowledgment letter sent by the Bureau of Rate Setting.
Case Service/Service Coordination to Willowbrook Class Members
- State Paid Service to Willowbrook Class Members who are not MSC Enrolled Voluntary provider agencies can be authorized to provide case management/service coordination to Willowbrook Case Members who are not eligible for Medicaid Service Coordination (MSC) due to the living setting of the Class Member. This document provides additional information on the services, applicable fees, establishing price ID for billing, claim submission and other helpful information for OPWDD and provider agency staff.
OPWDD Template Funding
The intent of the OPWDD Template Funding is to provide reimbursement clarity to service providers who are willing to assist individuals, who meet select criteria, with living richer lives. The "template" values, eliminate the need for budget negotiation. The service provider retains the template value funding only while serving the individual. If an individual chooses to receive service from another provider, the funding follows the individual to the new service provider.