Mississippi adjusts HCBS rates and EVV billing

Mississippi Medicaid will implement updated payment rates for home and community-based services (HCBS) starting January 1, 2026. These changes affect services authorized under the 1915(c) and 1915(i) waivers and require providers to follow new billing procedures.

Updated fee schedule for HCBS

The Mississippi Division of Medicaid (DOM) issued a revised fee schedule that increases reimbursement rates for HCBS. This update applies to services delivered under both the 1915(c) waiver, which offers comprehensive support to individuals with intellectual and developmental disabilities (IDD), and the 1915(i) State Plan HCBS program. Providers must use the new billing codes, taxonomies, and code combinations exactly as specified in the updated fee schedule to ensure claims are processed correctly.

EVV billing requirements

For providers submitting claims that require electronic visit verification (EVV), DOM mandates a critical update to billing configurations within the HHAeXchange EVV system. By January 1, 2026, providers must manually update the “Billing Rate” in the system to reflect the new fee structure before submitting claims. Failure to complete this update may result in claim denials or incorrect reimbursement amounts under the revised rates.

DOM has provided detailed guidance on how to implement these changes, both through its official bulletin and the HHAeXchange Knowledge Base. Providers are advised to review these resources promptly to avoid disruptions in billing workflows.

Importance of timely compliance

The upcoming changes highlight the need for prompt action from HCBS providers in Mississippi. Adjusting internal billing systems and ensuring alignment with the new rates and EVV requirements will help maintain uninterrupted Medicaid reimbursement. Providers should prioritize understanding and applying these updates ahead of the January 1, 2026 deadline.