D.C. Mun. Regs. tit. 29, r. 4216
The reimbursement rate for assisted living services during Waiver Year 5 shall be sixty dollars ($60.00) per day.
The reimbursement rate for assisted living services during Waiver Year 1 of the Renewal shall be one hundred fifty five ($155) dollars per day.
The rate shall be an all- inclusive rate for all services provided as set forth in Section 4238.
Medicaid reimbursement will not be made for twenty-four (24) hour skilled care, costs of facility maintenance, upkeep and improvement, and room and board. Covered services shall be in accordance with Section 4238.
Beneficiaries may seek subsidies outside of the Home and Community Based Waiver for Persons who are Elderly and Individuals with Physical Disabilities (EPD Waiver) to pay for room and board through the Optional State Supplemental Payment Program.
DHCF shall not reimburse for assisted living services provided concurrently with the following EPD Waiver services:
PCA services are included for beneficiaries residing in assisted living as part of the all- inclusive rate. Therefore, a Home Care Agency cannot bill for Personal Care Aide Services for a beneficiary who is concurrently receiving assisted living services.
D.C. Mun. Regs. tit. 29, r. 4216