I/DD Waivers in West Virginia
I/DD Waivers in West Virginia
All states: Medicaid disability services map
In short: A single 1915(c) IDD Waiver run by BMS pays providers fee-for-service; 1,280 people were on its managed enrollment list in August 2026.
West Virginia I/DD services at a glance
| State I/DD agency | Bureau for Medical Services (BMS), West Virginia Department of Human Services. BMS is both the Medicaid agency and the waiver operator. |
|---|---|
| I/DD waivers | 1 1915(c) waiver: the Intellectual/Developmental Disabilities Waiver (IDDW) |
| How Medicaid pays | Fee-for-service. Waivers are carved out of Mountain Health Trust managed care, and BMS pays claims through its fiscal agent. |
| Waiting list | 1,280 waiting on the Managed Enrollment List (August 31, 2026) |
| Front door | Application to Acentra Health, the utilization management contractor |
| Assessment tool | ICAP (Inventory for Client and Agency Planning) |
| Self-direction | Available through Personal Options, except for people in licensed residential settings |
| EVV for I/DD services | Partly. Home-Based Agency Person-Centered Support and respite. HHAeXchange is free, or agencies can use their own system. |
Last verified against state sources: 2026-10-28.
Who runs I/DD services in West Virginia?
The Bureau for Medical Services (BMS), part of the West Virginia Department of Human Services (DoHS), runs I/DD home and community services. BMS is both the state Medicaid agency and the agency that operates the waiver, so West Virginia has no separate developmental disabilities agency running the program. BMS hires contractors for day-to-day tasks such as applications, assessments and budgets, and case management agencies coordinate each person's services.
- Bureau for Medical Services (BMS): runs the Intellectual/Developmental Disabilities Waiver (IDDW) Program, sets rates and policy, and pays providers.
- Acentra Health: the utilization management contractor (UMC). It takes applications, does the annual face-to-face assessment, sets individualized budgets, handles prior authorization and manages the waiting list.
- Medical eligibility: a Medical Eligibility Contracted Agent decides who is medically eligible. We did not find which organization currently holds this contract.
- Financial eligibility: the local DoHS office decides financial eligibility once a funded slot is released.
- Case management: case managers work for conflict-free case management agencies that the member picks on a Freedom of Choice form. A case management agency cannot provide other services to the same member without an exception from BMS. Case managers visit in person monthly for people in 24-hour or Specialized Family Care settings and quarterly for people living in their natural family home.
What Medicaid waivers and programs serve people with I/DD in West Virginia?
West Virginia has one I/DD waiver, the Intellectual/Developmental Disabilities Waiver (IDDW). It is a 1915(c) waiver, a federal Medicaid option that lets a state pay for home and community services instead of institutional care. CMS approved its five-year renewal (control number WV.0133.R08) on June 18, 2025, effective July 1, 2025.
- Who it serves: children age 3 and older and adults with an intellectual disability or a related condition that began before age 22, with substantial adaptive deficits in at least 3 of 6 major life areas, who need the level of care provided in an ICF/IID.
- Size: the CMS approval allows 6,165 people a year, with 12 slots a year (6 adults, 6 children) reserved under the Benjamin H. court order. BMS's August 2026 waiver report lists 6,400 CMS-approved slots for August 2026, up from 6,165 in July. We did not find the amendment that explains the increase.
- Main services: Case Management; Facility-Based Day Habilitation; Prevocational Services; Supported Employment; Job Development; Home-Based Agency Person-Centered Support; Family Person-Centered Support; Licensed Group Home Person-Centered Support; Unlicensed Residential Person-Centered Support; Crisis Intervention and Crisis Site Person-Centered Support; In-Home and Out-of-Home Respite; Behavior Support Professional; Skilled Nursing (RN and LPN) and Skilled Nursing Medication Administration; physical, occupational, speech and dietary therapy; Electronic Monitoring; Environmental Accessibility Adaptations; Non-Medical Transportation; and Participant-Directed Goods and Services.
- Limits: every member has an individualized annual budget, and services above it need an approved exception. Day services have annual unit limits, described below.
- Recent changes in the renewal: the 2025 renewal added Skilled Nursing Medication Administration, expanded telehealth and moved case management visits for people in natural family homes to quarterly in person.
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) are the institutional option that the IDDW is an alternative to. BMS also runs the Children with Serious Emotional Disorder Waiver, the Traumatic Brain Injury Waiver and the Aged and Disabled Waiver, which are related programs but not I/DD waivers.
Does West Virginia pay for I/DD services through managed care?
No. Home and community-based waivers, including the IDDW, are carved out of Mountain Health Trust, West Virginia's Medicaid managed care program. BMS pays IDDW providers fee-for-service through its fiscal agent, Gainwell Technologies.
- Who authorizes services: Acentra Health, the utilization management contractor, sets budgets and handles prior authorization.
- Who pays claims: BMS, through Gainwell Technologies.
- Who coordinates services: case managers at conflict-free case management agencies chosen by the member.
Is there a waiting list for I/DD services in West Virginia?
Yes. When all funded slots are full, people who are medically eligible go on the Managed Enrollment List (MEL). BMS reported 1,280 applicants on the list at the end of August 2026, and the longest wait on the list was 1,890 days, according to its August 2026 waiver report.
- Order: first come, first served, by the date and time a person's medical eligibility was determined.
- Reserved slots: 12 slots a year (6 adults, 6 children) are set aside under the Benjamin H. court order for certain people in institutions.
- Where people wait: BMS's report also counts how many people on the list live in ICF/IID group homes.
For questions about a person's place on the list, families can contact Acentra Health at (866) 385-8920 or the IDDW Program at BMS at (304) 558-1700.
How do people apply for the IDD Waiver, and how are budgets set?
People apply by sending an application to Acentra Health by mail, fax ((866) 521-6882) or email (WVIDDWaiver@acentra.com). The applicant then picks a psychologist from the Independent Psychologist Network for an Independent Psychological Evaluation. Each member gets an individualized budget built from a base amount plus add-ons tied to ICAP assessment scores.
- Medical eligibility: decided by the Medical Eligibility Contracted Agent from the psychological evaluation, using standardized tests. The person needs a diagnosis of I/DD or a related condition before age 22, substantial adaptive deficits in 3 of 6 major life areas and a need for ICF/IID level of care. Medical eligibility is checked again every year.
- Financial eligibility: decided by the local DoHS office after a funded slot is released.
- Assessment: Acentra Health does an annual face-to-face functional assessment using the Inventory for Client and Agency Planning (ICAP).
- Budgets: for anchor dates on or after October 1, 2024, the annual budget is a base range set by the person's age and living setting, plus add-on amounts based on ICAP scores. Services above the budget need an approved exception.
What day and residential services can I/DD providers offer in West Virginia?
IDDW providers can offer four day and employment services and several residential supports. All IDDW providers must be licensed behavioral health centers, and the day services are billed in 15-minute units at ratio-specific rates. Group homes are licensed by the DoHS Office of Health Facility Licensure and Certification (OHFLAC).
Day and employment services
- Facility-Based Day Habilitation: training and support at a licensed site in self-care, community, social, communication and independent living skills, for people 18 and older. The provider needs a WV Behavioral Health License from OHFLAC with the site listed on it. Billed at 1:1-2, 1:3-4 and 1:5-6 staff-to-member ratios in 15-minute units, with an annual limit of 6,240 units shared with other day habilitation services.
- Prevocational Services: services that build a path to competitive community jobs, for people 18 and older who are not in public school. Billed at the same three ratios in 15-minute units, with an annual limit of 6,240 units.
- Supported Employment: job coaching, on-the-job training and ongoing support for people 18 and older in paid, integrated jobs. Billed at 1:1 and 1:2 or more in 15-minute units, with an annual limit of 8,320 units.
- Job Development: one-to-one help finding and getting a community job, billed in 15-minute units with an annual limit of 6,240 units.
Residential services
- Licensed Group Home Person-Centered Support: awake and alert staff support for adults in a licensed group home. Any home owned or leased by an IDDW provider, or with more than 3 residents, must be licensed by OHFLAC.
- Unlicensed Residential Person-Centered Support: awake and alert support from staff who do not live in the home, in apartments or houses rented or leased by 1 to 3 unrelated people. Homes owned or leased by an IDDW provider do not qualify, and family members cannot be paid for this service. It can be provided by a licensed behavioral health center or self-directed through Personal Options.
- Family Person-Centered Support and Specialized Family Care: support from family members or Specialized Family Care (foster care) providers who live in the home. Out-of-Home Respite is also offered in certified Specialized Family Care homes. We did not confirm which office certifies these homes.
- ICF/IID: the institutional option, paid under the Medicaid state plan rather than the waiver.
How are I/DD provider rates set and how do agencies enroll in West Virginia?
BMS sets fee-for-service rates using a rate build method, where each rate is built from cost components. Myers and Stauffer LLC reviews the rates every year using provider cost reports, wage data from the Bureau of Labor Statistics and national benchmarks, and BMS makes the final decision. IDDW rates rose 9% on October 1, 2025, after a 15% increase for home and community services in October 2024.
- Rate chart: the current BMS IDDW rate chart is effective October 1, 2025. Most services are paid in 15-minute units, with separate codes by staff ratio. For example, Licensed Group Home Person-Centered Support pays $7.47 per 15-minute unit at a 1:1 ratio.
- Becoming a provider: IDDW providers must be licensed behavioral health centers. A new agency goes through the Certificate of Need process or the expedited summary review, gets a behavioral health license from OHFLAC, then signs a Medicaid provider agreement and enrolls with Gainwell Technologies, the BMS fiscal agent.
- EVV: electronic visit verification (EVV) applies to Home-Based Agency Person-Centered Support, In-Home Respite and Out-of-Home Respite. West Virginia uses an open, hybrid model: agencies can use the free HHAeXchange system or their own compatible EVV system at their own cost, and HHAeXchange collects the data from other systems. Details are on the state's EVV page.
What is changing next for I/DD services in West Virginia?
As of October 28, 2026, we did not find a confirmed upcoming change with a set date for West Virginia's I/DD services. The most recent change is a revised Chapter 513 IDDW policy manual that took effect August 1, 2026. We could not open the manual, so this page does not describe what changed in it. Providers should read it on the BMS site.
Other recent changes already in place include the 9% rate increase on October 1, 2025, the 2025 waiver renewal, and the rise to 6,400 approved slots shown in the August 2026 BMS report. For news on future amendments, check the IDDW waiver and reports page or call the IDDW Program at (304) 558-1700.
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Who to ask about I/DD services in West Virginia
Questions about I/DD services in West Virginia are best put to the state. Start with Intellectual/Developmental Disabilities Waiver (IDDW) Program. Published contact: IDDW Program, Bureau for Medical Services: (304) 558-1700. Applications to Acentra Health: WVIDDWaiver@acentra.com or (866) 385-8920.
West Virginia I/DD sources
- West Virginia BMS: Intellectual/Developmental Disabilities Waiver (IDDW) Program
- West Virginia BMS: IDDW waiver document (WV.0133.R08, 2025 renewal)
- CMS approval of the IDDW renewal (June 18, 2025)
- West Virginia BMS: IDDW rate chart (effective October 1, 2025)
- West Virginia BMS: IDDW waiver report (August 2026)
- West Virginia BMS: Mountain Health Trust managed care
- West Virginia Governor's Office: HCBS rate increase announcement (October 3, 2025)
- West Virginia BMS: Gainwell Technologies provider enrollment
- West Virginia waiver programs: Electronic Visit Verification (EVV)
- West Virginia BMS: Chapter 513 IDDW policy manual
Related reading
- Disability Services and Independent Living Guide
- Developmental Disabilities vs. Mental Health: Key Differences
- Disability Services DayHab has a dilemma - how to solve it
- Essential Acronyms in Disability Services: A Quick Reference Guide
- I/DD services in every state (map)
- West Virginia EVV requirements
Page history
- October 28, 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.
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Questions about EVV?
EVV is still to be implemented in most of the states with different guidelines and regulations. We’re keeping up with the updates related to EVV implementation and if there is something we haven’t included, please share with us. To learn how ankota can help in ensuring compliance, please get in touch with us.
West Virginia I/DD questions
Who runs I/DD waiver services in West Virginia?
The Bureau for Medical Services (BMS) in the West Virginia Department of Human Services is both the Medicaid agency and the operating agency for the Intellectual/Developmental Disabilities Waiver (IDDW). Acentra Health is the utilization management contractor and handles applications, annual assessments, budgets, prior authorization and the Managed Enrollment List.
How do I apply for the IDD Waiver in West Virginia?
Send an application to Acentra Health by mail, fax at (866) 521-6882 or email at WVIDDWaiver@acentra.com. You then choose a psychologist from the Independent Psychologist Network for an evaluation, which is used to decide medical eligibility. Financial eligibility is checked by the local DoHS office once a funded slot opens.
Is there a waiting list for the IDD Waiver?
Yes. When slots are full, medically eligible applicants go on the Managed Enrollment List in order of the date their medical eligibility was determined. BMS reported 1,280 applicants on the list at the end of August 2026. Twelve slots a year are reserved under the Benjamin H. court order for certain people in institutions.
Are IDD Waiver services paid through managed care?
No. Home and community-based waivers are carved out of the Mountain Health Trust managed care program. BMS pays IDDW providers fee-for-service through its fiscal agent, Gainwell Technologies.
What does an agency need to become an IDDW provider?
IDDW providers must be licensed behavioral health centers. A new agency goes through the Certificate of Need process or the expedited summary review, gets a behavioral health license from OHFLAC, then signs a Medicaid provider agreement and enrolls with Gainwell Technologies.
How are IDDW day services billed?
Facility-Based Day Habilitation and Prevocational Services are billed in 15-minute units at 1:1-2, 1:3-4 and 1:5-6 staff ratios, each with an annual limit of 6,240 units. Supported Employment is billed at 1:1 or 1:2 or more with a limit of 8,320 units, and Job Development is one-to-one. These services are for people 18 and older.
Can families self-direct IDDW services?
Yes. Through Personal Options, members can hire their own workers and manage part of their budget, with a single fiscal/employer agent handling payroll. Self-direction is not available to people living in OHFLAC-licensed residential settings.
Which IDDW services require electronic visit verification?
EVV applies to Home-Based Agency Person-Centered Support and respite services. West Virginia uses an open, hybrid model, so providers can use the free HHAeXchange system or their own compatible EVV system at their own cost.