Find & Ask › Tennessee › this rule

Methodology Utilized To Determine Payments To Service Providers (Rate Structure), Tenn. Comp. R. & Regs. Chapter 0465-01-02 (rulemaking hearing filing, DIDD)

TennesseeregulationTennessee Department of Intellectual and Developmental Disabilities (DIDD)

What this rule requires your agency to do

  • 1Personal Assistance is reimbursed at one (1) maximum rate per one-quarter (1/4) hour unit (0465-01-02-.12(3)).(Methodology Utilized To Determine Payments To Service Providers (Rate Structure), Tenn. Comp. R. & Regs. Chapter 0465-01-02 (rulemaking hearing filing, DIDD))
  • 2All rate methodologies are subject to the availability of appropriations in the TennCare budget and may be adjusted by the Department or TennCare to keep expenditures within the budgeted amount for waiver services (0465-01-02-.02(1)).(Methodology Utilized To Determine Payments To Service Providers (Rate Structure), Tenn. Comp. R. & Regs. Chapter 0465-01-02 (rulemaking hearing filing, DIDD))
  • 3Providers must complete and transmit the Uniform Cost Report in the manner, format and timeframe required by the Division (0465-01-02-.03(1)(j)).(Methodology Utilized To Determine Payments To Service Providers (Rate Structure), Tenn. Comp. R. & Regs. Chapter 0465-01-02 (rulemaking hearing filing, DIDD))
  • 4The Regional Office must review any special needs adjustment at least annually (0465-01-02-.08(4)(b)).(Methodology Utilized To Determine Payments To Service Providers (Rate Structure), Tenn. Comp. R. & Regs. Chapter 0465-01-02 (rulemaking hearing filing, DIDD))
  • 5Respite services are reimbursed at one (1) maximum rate per one-quarter (1/4) hour unit (0465-01-02-.12(4)).(Methodology Utilized To Determine Payments To Service Providers (Rate Structure), Tenn. Comp. R. & Regs. Chapter 0465-01-02 (rulemaking hearing filing, DIDD))
  • 6Reimbursement for two (2) staff to deliver services to one (1) service recipient at the same time is not covered under any circumstances for respite and personal assistance services (0465-01-02-.12(2)).(Methodology Utilized To Determine Payments To Service Providers (Rate Structure), Tenn. Comp. R. & Regs. Chapter 0465-01-02 (rulemaking hearing filing, DIDD))

Applies to: DIDD-approved service providers, including providers of personal assistance and respite services

Establishes the rate-setting methodologies DIDD uses to pay approved providers of waiver services, including quarter-hour rate methodology and staffing limits for Personal Assistance and Respite services.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.