The Iowa Department of Health and Human Services (HHS), pursuant to the requirements outlined in 42 C.F.R. ยง447.205, hereby gives notice of the following proposed action regarding the addition of a new service and the accompanying rates to the State Plan under Title XIX of the Social Security Act (Medicaid). 


Summary of Submission: 

State Plan Amendment (SPA) IA-24-0002 is being submitted to the Centers for Medicare and Medicaid Services (CMS) to add Therapeutic Foster Care  as a covered Medicaid rehabilitative service under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit for members under age 21, including setting forth licensed child placing agencies who contract with licensed and specially trained foster parents to serve children in the community as the provider type that may provide the service. SPA IA-24-0002 also implements the Medicaid reimbursement rates in the table below for Therapeutic Foster Care. Pending CMS approval, the anticipated effective date of the SPA is July 1, 2024. 

Medicaid State Plan Amendment (SPA) IA-24-0002 will amend Attachment 4.19-B, page 5, to indicate the fee schedule effective date for behavioral health service providers is July 1, 2024. 

HHS partnered with Family Well Being and Protection (FWBP) to develop a per diem rate for the Therapeutic Foster Care service. Each Therapeutic Foster Family will receive a base rate from FWBP, a Level 3/Difficulty of Care payment from FWBP, and a Medicaid payment on a day the service is provided. FWBP has slightly different rates for youth in different age brackets. As such, the Medicaid per diem varies slightly between the rate paid for younger youth and the rate paid for older youth

H2020 U4 (ages 11 and under)H2020 U5 (ages 12 and over)


Estimated Fiscal Impact: 

The estimated increase in Medicaid fee-for-service (FFS) expenditures for State Fiscal Year (SFY) 2025 related to the Therapeutic Foster Care rate is: 

Total Dollars:         $ 52,234.20

Federal Dollars:      $ 33,153.05 

State Dollars:         $ 19,081.15


Public Review and Comments:  

A copy of SPA IA-24-0002 is posted below, under Related Files.  To reach all stakeholders, non-electronic copies will be made available for public review at each local HHS office. 


Submission of Comments:  

Written comments may be sent to Hannah Olson, Department of Health and Human Services, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319 or may be emailed to Please indicate SPA IA-24-0002 in the subject line of the email.  

All written and emailed comments must be received no later than Monday, July 8, 2024 by 4:30 p.m. 


Submitted by: 

Elizabeth Matney
Iowa Medicaid Director
Iowa Department of Health and Human Services