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Division of Developmental Disabilities
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HCBS Independent Rates for Qualified Vendors
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Effective For WellSky Implementation
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HCPC Conversion
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Update 5/23/22
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Service CodeHCPCModifierPositionUnit of ServicePer Unit RateStart DateEnd DateDescription
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A9270A9270Daily$180.0010/1/20219/30/2022Non-covered services due to member absence for Sign Language or Oral Interpretive Services, daily
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ATCS5125Per 15-Minutes$5.1310/1/20219/30/2022Attendant Care: 1; Statewide
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ATCS5125Per 15-Minutes$3.2110/1/20219/30/2022Attendant Care: 2; Statewide
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ATCS5125Per 15-Minutes$2.5710/1/20219/30/2022Attendant Care: 3; Statewide
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ATCS5125Per 15-Minutes$6.0310/1/20219/30/2022Attendant Care: 1; Flagstaff
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ATCS5125Per 15-Minutes$3.7710/1/20219/30/2022Attendant Care: 2; Flagstaff
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ATCS5125Per 15-Minutes$3.0210/1/20219/30/2022Attendant Care: 3; Flagstaff
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ATCS5125Per 15-Minutes$5.044/1/20216/30/2021Attendant Care: 1; Statewide, Incentive Rate
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ATCS5125Per 15-Minutes$3.154/1/20216/30/2021Attendant Care: 2; Statewide, Incentive Rate
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ATCS5125Per 15-Minutes$2.524/1/20216/30/2021Attendant Care: 3; Statewide, Incentive Rate
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ATCS5125Per 15-Minutes$5.944/1/20216/30/2021Attendant Care: 1; Flagstaff, Incentive Rate
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ATCS5125Per 15-Minutes$3.714/1/20216/30/2021Attendant Care: 2; Flagstaff, Incentive Rate
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ATCS5125Per 15-Minutes$2.974/1/20216/30/2021Attendant Care: 3; Flagstaff, Incentive Rate
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ATCS5125Per 15-Minutes$5.541/1/20213/31/2021Attendant Care: 1; Statewide, Incentive Rate
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ATCS5125Per 15-Minutes$3.461/1/20213/31/2021Attendant Care: 2; Statewide, Incentive Rate
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ATCS5125Per 15-Minutes$2.771/1/20213/31/2021Attendant Care: 3; Statewide, Incentive Rate
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ATCS5125Per 15-Minutes$6.441/1/20213/31/2021Attendant Care: 1; Flagstaff, Incentive Rate
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ATCS5125Per 15-Minutes$4.031/1/20213/31/2021Attendant Care: 2; Flagstaff, Incentive Rate
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ATCS5125Per 15-Minutes$3.221/1/20213/31/2021Attendant Care: 3; Flagstaff, Incentive Rate
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ATCS5125Per 15-Minutes$4.731/1/20219/30/2021Attendant Care: 1; Statewide
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ATCS5125Per 15-Minutes$2.961/1/20219/30/2021Attendant Care: 2; Statewide
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ATCS5125Per 15-Minutes$2.371/1/20219/30/2021Attendant Care: 3; Statewide
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ATCS5125Per 15-Minutes$5.631/1/20219/30/2021Attendant Care: 1; Flagstaff
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ATCS5125Per 15-Minutes$3.521/1/20219/30/2021Attendant Care: 2; Flagstaff
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ATCS5125Per 15-Minutes$2.821/1/20219/30/2021Attendant Care: 3; Flagstaff
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CBET2019HQPer 15-Minutes$1.5910/1/20219/30/2022Center-Based Employment-High Density Staff: Member Ratio of 1:4.5 To 1:7.5; Statewide; Urban
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CBET2019HQPer 15-Minutes$1.7210/1/20219/30/2022Center-Based Employment-Low Density : Member Ratio of 1:4.5 To 1:7.5; Statewide; Rural
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CBET2019HQPer 15-Minutes$1.8510/1/20219/30/2022Center-Based Employment-High Density: Member Ratio of 1:4.5 To 1:7.5; Flagstaff; Urban
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CBET2019HQPer 15-Minutes$9.5310/1/20219/30/2022Center-Based Employment (High Density) (1:1); Statewide
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CBET2019HQPer 15-Minutes$10.2810/1/20219/30/2022Center-Based Employment (Low Density) (1:1); Statewide
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CBET2019HQPer 15-Minutes$2.3810/1/20219/30/2022Center-Based Employment (High Density) (1:4); Statewide
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CBET2019HQPer 15-Minutes$2.5710/1/20219/30/2022Center-Based Employment (Low Density) (1:4); Statewide
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CBET2019HQPer 15-Minutes$3.1810/1/20219/30/2022Center-Based Employment (High Density) (1:3); Statewide
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CBET2019HQPer 15-Minutes$3.4310/1/20219/30/2022Center-Based Employment (Low Density) (1:3); Statewide
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CBET2019HQPer 15-Minutes$4.7710/1/20219/30/2022Center-Based Employment (High Density) (1:2); Statewide
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CBET2019HQPer 15-Minutes$5.1410/1/20219/30/2022Center-Based Employment (Low Density) (1:2); Statewide
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CBET2019HQPer 15-Minutes$1.591/1/20219/30/2021Center-Based Employment-High
Density Staff: Member
Ratio of 1:4.5 To 1:7.5; Statewide; Urban
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CBET2019HQPer 15-Minutes$1.721/1/20219/30/2021Center-Based Employment-Low Density : Member
Ratio of 1:4.5 To 1:7.5; Statewide; Rural
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CBET2019HQPer 15-Minutes$1.801/1/20219/30/2021Center-Based Employment-High
Density: Member
Ratio of 1:4.5 To 1:7.5; Flagstaff; Urban
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CBET2019HQPer 15-Minutes$9.201/1/20219/30/2021Center-Based Employment (High Density) (1:1); Statewide
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CBET2019HQPer 15-Minutes$9.951/1/20219/30/2021Center-Based Employment (Low Density) (1:1); Statewide
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CBET2019HQPer 15-Minutes$2.301/1/20219/30/2021Center-Based Employment (High Density) (1:4); Statewide
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CBET2019HQPer 15-Minutes$2.491/1/20219/30/2021Center-Based Employment (Low Density) (1:4); Statewide
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CBET2019HQPer 15-Minutes$3.071/1/20219/30/2021Center-Based Employment (High Density) (1:3); Statewide
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CBET2019HQPer 15-Minutes$3.321/1/20219/30/2021Center-Based Employment (Low Density) (1:3); Statewide
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CBET2019HQPer 15-Minutes$4.601/1/20219/30/2021Center-Based Employment (High Density) (1:2); Statewide
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CBET2019HQPer 15-Minutes$4.981/1/20219/30/2021Center-Based Employment (Low Density) (1:2); Statewide
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CPRT2019Per 15-Minutes$8.4110/1/20219/30/2022Career Preparation & Readiness; Statewide; Urban
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CPRT2019Per 15-Minutes$8.9210/1/20219/30/2022Career Preparation & Readiness; Statewide; Rural
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CPRT2019Per 15-Minutes$8.091/1/20219/30/2021Career Preparation & Readiness; Statewide; Urban
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CPRT2019Per 15-Minutes$8.591/1/20219/30/2021Career Preparation & Readiness; Statewide; Rural
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DTAT2021Per 15-Minutes$2.8510/1/20219/30/2022Day Treatment and Training, Adult - Staff
Member Ratio Of 1:2.5 To 1:4.5: Statewide
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DTAT2021Per 15-Minutes$2.1810/1/20219/30/2022Day Treatment and Training, Adult - Staff
Member Ratio Of 1:4.51 To 1:6.5: Statewide
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DTAT2021Per 15-Minutes$1.8810/1/20219/30/2022Day Treatment and Training, Adult - Staff
Member Ratio Of 1:6.51 To 1:8.5: Statewide
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DTAT2021Per 15-Minutes$3.1010/1/20219/30/2022Day Treatment and Training, Adult - Staff
Member Ratio Of 1:2.5 To 1:4.5: Flagstaff
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DTAT2021Per 15-Minutes$2.3410/1/20219/30/2022Day Treatment and Training, Adult - Staff
Member Ratio Of 1:4.51 To 1:6.5: Flagstaff
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DTAT2021Per 15-Minutes$2.0010/1/20219/30/2022Day Treatment and Training, Adult - Staff
Member Ratio Of 1:6.51 To 1:8.5: Flagstaff
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DTAT2021Per 15-Minutes$3.1210/1/20219/30/2022Day Treatment and Training, Adult, Rural - Staff : Member Ratio Of 1:2.5 To 1:4.5: Statewide
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DTAT2021Per 15-Minutes$2.3810/1/20219/30/2022Day Treatment and Training, Adult, Rural - Staff : Member Ratio Of 1:4.51 To 1:6.5: Statewide
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DTAT2021Per 15-Minutes$2.0210/1/20219/30/2022Day Treatment and Training, Adult, Rural - Staff : Member Ratio Of 1:6.51 To 1:8.5: Statewide
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DTAT2021Per 15-Minutes$6.4110/1/20219/30/2022Behaviorally or Medically Intense Day Treatment and Training, Adult - Staff : Member Ratio Of 1:1: Statewide
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DTAT2021Per 15-Minutes$3.9710/1/20219/30/2022Behaviorally or Medically Intense Day Treatment and Training, Adult - Staff : Member Ratio Of 1:2: Statewide
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DTAT2021Per 15-Minutes$7.2110/1/20219/30/2022Behaviorally or Medically Intense Day Treatment and Training, Adult - Staff : Member Ratio Of 1:1: Flagstaff
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DTAT2021Per 15-Minutes$4.4710/1/20219/30/2022Behaviorally or Medically Intense Day Treatment and Training, Adult - Staff : Member Ratio Of 1:2: Flagstaff
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DTAT2021Per 15-Minutes$2.761/1/20219/30/2021Day Treatment and Training, Adult - Staff
Member Ratio Of 1:2.5 To 1:4.5: Statewide
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DTAT2021Per 15-Minutes$2.121/1/20219/30/2021Day Treatment and Training, Adult - Staff
Member Ratio Of 1:4.51 To 1:6.5: Statewide
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DTAT2021Per 15-Minutes$1.831/1/20219/30/2021Day Treatment and Training, Adult - Staff
Member Ratio Of 1:6.51 To 1:8.5: Statewide
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DTAT2021Per 15-Minutes$3.011/1/20219/30/2021Day Treatment and Training, Adult - Staff
Member Ratio Of 1:2.5 To 1:4.5: Flagstaff
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DTAT2021Per 15-Minutes$2.281/1/20219/30/2021Day Treatment and Training, Adult - Staff
Member Ratio Of 1:4.51 To 1:6.5: Flagstaff
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DTAT2021Per 15-Minutes$1.961/1/20219/30/2021Day Treatment and Training, Adult - Staff
Member Ratio Of 1:6.51 To 1:8.5: Flagstaff
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DTAT2021Per 15-Minutes$3.031/1/20219/30/2021Day Treatment and Training, Adult, Rural - Staff : Member Ratio Of 1:2.5 To 1:4.5: Statewide
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DTAT2021Per 15-Minutes$2.321/1/20219/30/2021Day Treatment and Training, Adult, Rural - Staff : Member Ratio Of 1:4.51 To 1:6.5: Statewide
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DTAT2021Per 15-Minutes$1.981/1/20219/30/2021Day Treatment and Training, Adult, Rural - Staff : Member Ratio Of 1:6.51 To 1:8.5: Statewide
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DTAT2021Per 15-Minutes$6.081/1/20219/30/2021Behaviorally or Medically Intense Day Treatment and Training, Adult - Staff : Member Ratio Of 1:1: Statewide
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DTAT2021Per 15-Minutes$3.801/1/20219/30/2021Behaviorally or Medically Intense Day Treatment and Training, Adult - Staff : Member Ratio Of 1:2: Statewide
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DTAT2021Per 15-Minutes$6.891/1/20219/30/2021Behaviorally or Medically Intense Day Treatment and Training, Adult - Staff : Member Ratio Of 1:1: Flagstaff
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DTAT2021Per 15-Minutes$4.311/1/20219/30/2021Behaviorally or Medically Intense Day Treatment and Training, Adult - Staff : Member Ratio Of 1:2: Flagstaff
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DTST2021HAPer 15-Minutes$3.2010/1/20219/30/2022Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:2.5 To 1:4.5: Statewide
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DTST2021HAPer 15-Minutes$2.5810/1/20219/30/2022Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:4.51 To 1:6.5: Statewide
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DTST2021HAPer 15-Minutes$2.3210/1/20219/30/2022Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:6.51 To 1:8.5: Statewide
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DTST2021HAPer 15-Minutes$3.4510/1/20219/30/2022Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:2.5 To 1:4.5: Flagstaff
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DTST2021HAPer 15-Minutes$2.7510/1/20219/30/2022Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:4.51 To 1:6.5: Flagstaff
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DTST2021HAPer 15-Minutes$2.4410/1/20219/30/2022Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:6.51 To 1:8.5: Flagstaff
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DTST2021HAPer 15-Minutes$3.5610/1/20219/30/2022Day Treatment and Training, Children, Rural
(Summer) - Staff : Member Ratio Of 1:2.5 To 1:4.5: Statewide
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DTST2021HAPer 15-Minutes$3.0010/1/20219/30/2022Day Treatment and Training, Children, Rural
(Summer) - Staff : Member Ratio Of 1:4.51 To 1:6.5: Statewide
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DTST2021HAPer 15-Minutes$2.7710/1/20219/30/2022Day Treatment and Training, Children, Rural
(Summer) - Staff : Member Ratio Of 1:6.51 To 1:8.5: Statewide
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DTST2021HAPer 15-Minutes$6.4110/1/20219/30/2022
Behaviorally or Medically Intense Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:1: Statewide
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DTST2021HAPer 15-Minutes$3.9710/1/20219/30/2022
Behaviorally or Medically Intense Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:2: Statewide
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DTST2021HAPer 15-Minutes$7.2110/1/20219/30/2022
Behaviorally or Medically Intense Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:1: Flagstaff
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DTST2021HAPer 15-Minutes$4.4710/1/20219/30/2022
Behaviorally or Medically Intense Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:2: Flagstaff
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DTST2021HAPer 15-Minutes$3.101/1/20219/30/2021Day Treatment and Training, Children (Summer) - Staff : Member Ratio Of 1:2.5 To 1:4.5: Statewide