Capital Add-On and Bridge Rate Eligibility for State Fiscal Year 2025
The DSHS Office of Rates Management will be calculating eligibility for the Capital Add-On rate and the Bridge Rate for State Fiscal Year 2025 on Monday, May 6th, 2024. This calculation will be performed for all facilities with Assisted Living, Adult Residential Care, Enhanced Adult Residential Care, and/or Specialized Dementia Care contracts. It is strongly recommended that all providers have their claims for the qualification period (July 1, 2023 – December 31, 2023) submitted in ProviderOne by the end of April in order to ensure that those claims are included in the eligibility calculation. Once the calculation is complete, an updated list of facilities eligible for these rates in FY2025 will be posted on the Office of Rates management website.
The Capital Add-On rate is an add-on rate of $5.42 per client per day. For each fiscal year, the only clients eligible to receive this rate are Assisted Living (T2031) clients at facilities which had Medicaid Occupancy of 60% or higher during the qualification period (the previous July 1 – December 31).
The Bridge Rate is an add-on rate of $20.99 per client per day, which has only been funded for FY2024 and FY2025. For Fiscal Year 2025, clients eligible for the Bridge Rate are Assisted Living (T2031), Adult Residential Care (T1020,U2), Enhanced Adult Residential Care (T1020,U3), and Specialized Dementia Care (T1020,U4) clients at facilities which had Medicaid Occupancy of 75% of higher during the qualification period (July 1, 2023 – December 31, 2023). This is a change from FY2024, when the Medicaid Occupancy threshold for the Bridge Rate was 90%.
Details on how Medicaid Occupancy is calculated can be found in the Capital Add-On Information Sheet. Please note that the calculation uses the number of licensed beds in a facility, regardless of how many beds a facility has internally designated as Medicaid beds.
