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Reimbursement for overhead expenses due to residential absence

Page posted: 10/01/03

Page reviewed: 4/18/16

Page updated: 4/18/16

Legal authority

Federally approved CAC, CADI, DD and BI Waiver plans, State Medicaid Manual, Part 4, section 4442.3, item 15


Even though providers may not bill for days when a person is absent from his or her residence, providers still will incur costs.

The Centers for Medicare & Medicaid Services (CMS) considers the overhead expense of days when the person is away from a residence as a part of a waiver provider’s cost of doing business. Those costs are built into residential service frameworks in the Disability Waiver Rate System.

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