I/DD Waivers in Nevada
All states: Medicaid disability services map
In short: ADSD regional centers run one ID waiver paid fee-for-service; 722 people were on the statewide waiver waitlist in June 2025.
Nevada I/DD services at a glance
| State I/DD agency | Aging and Disability Services Division (ADSD), Developmental Services, through three Regional Centers |
|---|---|
| I/DD waivers | 1 1915(c) waiver: the Waiver for Individuals with Intellectual and Developmental Disabilities (ID Waiver) |
| How Medicaid pays | Fee-for-service. Providers invoice ADSD, which bills Nevada Medicaid. Waiver enrollees are excluded from managed care. |
| Waiting list | 722 waiting (June 2025), on a statewide list ordered by priority and request date |
| Front door | The ADSD Regional Center for the person's area: Desert, Sierra or Rural |
| Assessment tool | Not published |
| Self-direction | Not offered. No participant-directed option is listed for the ID Waiver. |
| EVV for I/DD services | No. ID Waiver services (Provider Type 38) are not on Nevada's EVV list. |
Last verified against state sources: 2026-10-23.
Who runs I/DD services in Nevada?
Two state agencies share the work. The Aging and Disability Services Division (ADSD), through its Developmental Services program, runs I/DD services day to day through three Regional Centers. Nevada Medicaid (the Division of Health Care Financing and Policy, now part of the Nevada Health Authority) administers the waiver that pays for most of those services. The Regional Center is the front door, and each person is assigned an ADSD Service Coordinator.
- ADSD Developmental Services: operates the I/DD program, decides who is eligible, manages the waitlist, certifies providers and authorizes services. Providers send their invoices to ADSD.
- Nevada Medicaid: administers the ID Waiver, enrolls providers and publishes the rules in Chapter 2100 of its Medicaid Services Manual (MSM).
- Regional Centers: Desert Regional Center serves Clark County except its outlying rural areas, (702) 486-7850. Sierra Regional Center serves Washoe County, (775) 687-2600. Rural Regional Center serves the other counties and outlying Clark County, (775) 687-5162.
- Case management: Regional Center Service Coordinators are state staff. They write each person's person-centered support plan, link the person to providers and monitor services. This work is billed as Medicaid State Plan Targeted Case Management, not as a waiver service.
What Medicaid waivers and programs serve people with I/DD in Nevada?
Nevada has one 1915(c) waiver for I/DD: the Home and Community-Based Services Waiver for Individuals with Intellectual and Developmental Disabilities, called the ID Waiver. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. ADSD also pays for some of the same services with state money for people who are not on the waiver.
- ID Waiver (1915(c), control number 0125.R08.00): serves people of any age with an intellectual or developmental disability who have an open Regional Center case, qualify for Medicaid and meet the level of care for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). The Centers for Medicare and Medicaid Services (CMS) approved the current renewal on September 28, 2023, effective October 1, 2023 through September 30, 2028, according to the federal waiver listing. ADSD reported 3,197 waiver recipients in June 2025.
- Waiver services: Jobs and Day Training (day habilitation, prevocational services and career planning), supported employment, residential support services (intermittent supported living, shared living and 24-hour supported living), residential support management, behavioral consultation, training and intervention, counseling, non-medical transportation, nursing, nutrition counseling, dental services, Individual Directed Goods and Services, and benefits counseling. Respite does not appear in the waiver's service list.
- State-funded services: ADSD funds Supported Living Arrangement (SLA) and Jobs and Day Training (JDT) services with state General Fund money for some people who are not on the waiver.
- Targeted Case Management: a Medicaid State Plan service that pays for Regional Center service coordination for everyone with an open case.
The Physical Disabilities, Frail Elderly and Structured Family Caregiving waivers are separate programs and are not I/DD waivers. ICF/IID care is the institutional option the waiver is an alternative to. Nevada has a state-run ICF at Desert Regional Center and private ICF/IID providers.
Does Nevada pay for I/DD services through managed care?
No. People enrolled in a 1915(c) waiver, and people living in an ICF/IID, are excluded from Nevada Medicaid managed care, according to MSM Chapter 3600. ID Waiver services are paid fee-for-service, with ADSD in the middle.
- Who pays claims: ID Waiver providers enroll with Nevada Medicaid as Provider Type 38 (PT 38), but they send invoices to ADSD, not to Nevada Medicaid. ADSD then bills Nevada Medicaid.
- Authorization: before giving a service, the provider must check that an approved service authorization is in ADSD's Electronic Information Management System, according to the PT 38 billing guide.
- Who coordinates services: the ADSD Regional Center Service Coordinator, not a health plan.
Is there a waiting list for I/DD services in Nevada?
Yes. The ID Waiver is limited to the number of people the Legislature funds, and applicants who qualify go on a statewide waitlist. ADSD reported 722 people waiting in June 2025, the latest count we found from ADSD. Priority goes first to people in an ICF/IID or other institution, then to people at risk because of a crisis or loss of support, then to everyone else by the date they asked.
Important: an open waiver slot is not enough by itself. ADSD says a new waiver enrollment needs both a slot and Regional Center funding, and the budget for state fiscal years 2026 and 2027 added no money for new people in contracted services.
- June 2025 figures: ADSD's caseload statistics show 722 people waiting (up from 696 in May), 640 of them already on Medicaid, an average wait of 346 days, and 484 federal waiver slots still available.
- Who moves first: in an October 2025 memo, ADSD said Regional Centers are moving people already receiving state-funded SLA and JDT services onto the waiver and giving priority to people in crisis.
- State-funded services: since July 1, 2024, Developmental Services has put all new SLA and JDT requests on waitlists except emergent needs, because the second rate increase cost more than the Legislature projected, according to a January 2025 report to the Legislature.
For a newer count or a person's place on the list, ask the Regional Center for the area.
How do people apply for I/DD services in Nevada, and how are budgets set?
People apply by contacting the ADSD Regional Center for their area. A Regional Center intake team confirms the intellectual or developmental disability from assessments and records, and the person must meet ICF/IID level of care. The Division of Welfare and Supportive Services (DWSS) decides Medicaid financial eligibility. Nevada does not publish the name of an assessment tool used to set budgets or support levels.
- Processing time: as of September 30, 2025, ADSD reported 203 Developmental Services applications pending at Desert Regional Center and 20 at Rural Regional Center, with average processing times of 68 days at Desert, 131 days at Rural and 57 days at Sierra.
- After eligibility: people who meet the criteria go on the statewide waitlist by priority and referral date until ADSD gives them a waiver slot.
- Support plan: the Service Coordinator builds a person-centered support plan using social, health, risk or self-medication assessments.
- Support levels: 24-hour supported living and day services are paid at tiered rates, but we did not find a published tool or method that assigns a person to a tier. Ask the Regional Center or ADSD.
What day and residential services can I/DD providers offer in Nevada?
Nevada's day services are grouped as Jobs and Day Training (JDT), and its residential services are Supported Living Arrangements (SLA). Providers of both must be certified by ADSD under Chapter 435 of the Nevada Administrative Code (NAC 435). Supported living homes do not need a state facility license. The research did not find a published staff ratio for any day service.
Day and employment services (JDT)
- Day habilitation: regularly scheduled activities in a non-residential setting that build self-help, social and adaptive skills, with volunteer work, community integration and supported retirement options. It may not be vocational. Billed in 15-minute units (T2021) since April 1, 2024, replacing a daily rate.
- Prevocational services and career planning: job exploration, job shadowing, informational interviewing and interest assessment aimed at a regular job in the community. Prevocational services are billed in 15-minute units (T2047).
- Supported employment: help to get, keep or advance in a regular community job, billed in 15-minute units (T2019) with urban and rural rates.
Different non-residential services cannot be billed for the same time period, but the JDT codes T2019, T2021 and T2047 may be billed on the same day. JDT providers get a provisional certificate and then a full certificate after an ADSD quality assurance review, under NAC 435.
Residential services (SLA)
- 24-hour supported living (intensive SLA): support up to 24 hours a day from an agency in homes in regular neighborhoods, with no more than four people per home unless the Regional Center Program Manager approves more. Protective oversight hours are shared among residents unless one-on-one need is documented. Paid a daily rate (T2016) tiered by staffing, with urban and rural rates.
- Intermittent supported living: support from an individual or agency for people in their own home or family home who do not need one-on-one supervision or 24-hour care, with no more than two people per home unless approved. Billed in 15-minute units (T2017).
- Shared living: a person with a disability and a person, couple or family choose to live together, with support delivered as intermittent supported living. Shared living homes and provider-owned homes need Regional Center approval, and the provider needs a lease with each resident of a provider-owned home.
SLA certificates last up to three years, and staff who give medication need ADSD-approved medication administration certification.
How are I/DD provider rates set and how do agencies enroll in Nevada?
Nevada Medicaid publishes a fee schedule for Provider Type 38, and rate increases come from money the Legislature approves. The last increases took effect July 1, 2023 and April 1, 2024. To serve ID Waiver participants, an agency needs ADSD certification, two state agreements and Medicaid enrollment as PT 38.
- Fee schedule: the PT 38 fee schedule (rates as of July 2026) lists 24-hour supported living daily rates from $142.00 to $457.75 by tier and urban or rural location, plus an individually set rate of up to $1,800 a day.
- Latest rate change: Senate Bill 504 (2023) funded SLA and JDT increases on July 1, 2023 and April 1, 2024, about $105.7 million in Regional Center budgets. On April 1, 2024, 24-hour supported living moved from 15-minute units to tiered daily rates and JDT moved from a daily rate to 15-minute units.
- Rate reviews: Nevada Medicaid reviews each provider type's rates at least every four years. PT 38 was surveyed in the 2025 review (surveys were due November 7, 2025), but we did not find a result for PT 38.
- Enrollment: a provider must be certified or approved by ADSD Developmental Services under NRS and NAC 435 (Nevada's statutes and rules for these services), hold a Master Service Agreement with the state Purchasing Division and a Provider Service Agreement with ADSD, and enroll with Nevada Medicaid using the PT 38 enrollment checklist.
- EVV: electronic visit verification (EVV) is not required for ID Waiver services. PT 38 is not on Nevada's EVV provider type list, and the PT 38 billing guide has no EVV requirement. The state's Sandata EVV system covers personal care, home health and certain services in the Frail Elderly, Physical Disabilities and Structured Family Caregiving waivers.
What is changing next for I/DD services in Nevada?
As of October 23, 2026, we did not find a confirmed upcoming change with a set date for Nevada's I/DD services. The one item to watch is the 2025 rate review for Provider Type 38, which has not published a result for these services. We did not find when it will be released or whether it will lead to new rates.
Recent changes already in place:
- New waiver services: MSM Chapter 2100 was revised effective April 1, 2025 to add Individual Directed Goods and Services and Benefits Counseling, which CMS approved effective January 1, 2025. The revision also removed prior authorization for dental services and removed specific dollar limits to match the waiver.
- Billing changes: since April 1, 2024, 24-hour supported living is paid by tiered daily rate and JDT by 15-minute unit.
For news on waiver amendments or the next waitlist count, ask Nevada Medicaid or the Regional Center for the area.
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Who to ask about I/DD services in Nevada
Questions about I/DD services in Nevada are best put to the state. Start with Nevada Medicaid, Waiver for Individuals with Intellectual and Developmental Disabilities. Published contact: ADSD Regional Centers: Desert (702) 486-7850, Sierra (775) 687-2600, Rural (775) 687-5162.
Nevada I/DD sources
- Nevada Medicaid: Waiver for Individuals with Intellectual and Developmental Disabilities
- Medicaid.gov: Nevada ID Waiver (0125.R08.00)
- Nevada Medicaid Services Manual Chapter 2100 (effective April 1, 2025)
- Nevada Medicaid Services Manual Chapter 3600 (managed care)
- Nevada Medicaid: Provider Type 38 billing guidelines
- ADSD: Combined caseload statistics, June 2025
- ADSD: Developmental Services information memo, October 10, 2025
- ADSD: Intellectual and developmental disabilities services
- Nevada Legislature: Developmental Services program report, January 2025
- Nevada Medicaid: Electronic Visit Verification
Related reading
- Disability Services and Independent Living Guide
- Essential Acronyms in Disability Services: A Quick Reference Guide
- Disability Services DayHab has a dilemma - how to solve it
- What is Active Support in Disability Services?
- I/DD services in every state (map)
- Nevada EVV requirements
Page history
- October 23, 2026: Page rewritten and checked against state sources.
This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.
Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.
