Hawaii Medicaid Reimbursement Rates 2027: Care Plan & Fee

There’s no single number you can point to and call “the Hawaii Medicaid rate” for 2027. Ask that question and you’ll get a different answer depending on the service, the procedure code, the provider type, and whether the claim runs through fee-for-service Medicaid or a QUEST Integration managed care plan. Modifiers matter too.

For fiscal year 2027, the rate period runs July 1, 2026, through June 30, 2027. Med-QUEST’s QI-2614 is the memo doing the heavy lifting here — it’s the key FY2027 Medicaid FFS rate document you’ll want on hand.

Before diving into specifics, it’s worth checking how these rates compare to what other states pay. Our breakdown of Medicaid reimbursement rates by state puts Hawaii’s numbers in context.

Hawaii Medicaid Reimbursement Rates 2027 at a Glance

The Hawaii Department of Human Services runs the state’s Medicaid program through its Med-QUEST Division. Simple enough on paper.

Where it gets complicated is in how reimbursement actually gets calculated. Depending on what you’re billing, you might be dealing with:

  • Medicaid fee-for-service rates
  • CPT or HCPCS-based payment
  • Separate dental fee schedules
  • APR-DRG inpatient hospital reimbursement
  • FQHC/RHC prospective payment system (PPS)
  • HCBS service-specific rates
  • Nursing facility rates
  • Hospice rates
  • Facility-specific payment methodologies
  • QUEST Integration managed-care contracts

Ten different paths, ten different sets of rules. That’s the whole reason a single “Hawaii Medicaid rate” doesn’t exist.

Hawaii Medicaid FY2027 Rate Period

Rate InformationEffective Period
FY2027July 1, 2026–June 30, 2027
Calendar year 2027January 1–December 31, 2027
FY2027 institutional FFS memoQI-2614
General FFS schedule available in 2026June 1, 2026 schedule
Hospice nursing-facility ratesSeparate rate memorandum

Fiscal year and calendar year aren’t the same thing here, and mixing them up is an easy mistake. A rate labeled “2027” might have already gone into effect back in July 2026.

Hawaii Medicaid Fee Schedule 2027

The FFS fee schedule is the first stop for most providers looking up what a service pays. It lists procedure codes, descriptions, and maximum allowable amounts.

That said — the general schedule doesn’t cover everyone. Before you trust a listed amount, run through this:

  1. CPT, HCPCS or CDT code
  2. Provider type
  3. Modifier
  4. Place of service
  5. Effective date
  6. FFS or managed-care status
  7. Authorization requirements
  8. Applicable provider memo
  9. Facility or geographic differences
  10. Whether another payment methodology applies

Treat any number on that schedule as a starting point. Not a guarantee.

Hawaii Medicaid FFS vs. QUEST Integration

This distinction trips up more providers than almost anything else on this list. Fee-for-service Medicaid and QUEST Integration managed care run on entirely different tracks.

Hawaii routes a large share of beneficiaries through QUEST Integration. If your patient is on one of those plans, your reimbursement may come from the health plan’s contract — not the state’s published FFS schedule.

Payment MethodGeneral Approach
FFS MedicaidState-published fee or methodology
QUEST Integration MCOHealth plan/provider contract
Hospital inpatientAPR-DRG or applicable hospital methodology
FQHC/RHCPPS methodology
HCBSService-specific rates and modifiers
DentalSeparate dental fee schedule

Don’t substitute a general FFS amount for a contracted QUEST Integration rate. They’re not interchangeable, and assuming they are is how billing errors happen.

Hawaii Medicaid Hospital Reimbursement and APR-DRG

Hospital inpatient services under Medicaid FFS use the All Patient Refined Diagnosis Related Group system — APR-DRG for short. It’s been in place for applicable admissions since July 1, 2022.

Instead of paying line-by-line for every inpatient procedure, APR-DRG groups the entire hospital stay based on diagnosis and other clinical factors. One payment, built from several inputs:

  • APR-DRG classification
  • Severity of illness
  • Resource requirements
  • Hospital-specific factors
  • Admission date
  • Applicable payment rules
  • Whether the hospital falls under an exclusion

Hunting for a single “Hawaii Medicaid hospital rate” is a dead end. It doesn’t work that way.

Hawaii Medicaid Physician and Professional Rates

Physicians and other eligible professionals typically bill using CPT and HCPCS codes. The Med-QUEST FFS fee schedule is where you’d start — but it isn’t the whole picture. Provider rules and payment memoranda round it out.

There’s also Hawaii’s Section 1115 QUEST Integration demonstration to consider, which includes provider-payment provisions for primary care, behavioral health, and obstetric care. This demonstration runs January 8, 2025, through December 31, 2029, and its documentation lays out payment requirements for those categories, often referencing Medicare-based comparisons.

Does Hawaii Medicaid Pay 100% of Medicare?

Not across the board. Hawaii’s FFS methodology leans on Medicare-related benchmarks for certain services, but that’s not the same as every Medicaid procedure matching the current Medicare rate dollar-for-dollar.

Check the actual Medicaid code, the effective date, and the payment methodology before you assume parity with Medicare.

Hawaii Medicaid Dental Reimbursement Rates

Dental runs on its own fee schedule entirely, separate from everything above. Med-QUEST’s dental resources include a 2026 Medicaid Dental Fee Schedule effective April 1, 2026, alongside the dental provider manual. What determines your reimbursement:

  • CDT procedure code
  • Provider requirements
  • Benefit limitations
  • Authorization
  • Applicable location
  • Current fee schedule

One more wrinkle: dental claims go through Hawaii Dental Service, not the standard Medicaid FFS claims process. Different pipeline, different rules. Always pull the newest published dental schedule before calculating a 2027 reimbursement figure.

Hawaii Medicaid FQHC and RHC Rates

Federally Qualified Health Centers and Rural Health Clinics don’t get paid the standard physician fee per encounter. They’re reimbursed under a Prospective Payment System instead — a different model built around the encounter, not the individual code.

Med-QUEST publishes separate FQHC/RHC PPS rate memoranda for this. Before using a reimbursement figure, confirm:

  • Facility or provider name
  • PPS rate
  • Effective date
  • Encounter type
  • Applicable rate memorandum
  • Services included in the encounter

A general CPT fee is not the complete FQHC or RHC payment. Don’t treat it as one.

Hawaii Medicaid HCBS Reimbursement Rates

Home and Community-Based Services have their own reimbursement structure entirely, covering things like personal assistance, self-directed services, adult day services, home-delivered meals, skilled nursing, case management, personal emergency response, and residential care.

Here’s what the published 2026 FFS HCBS schedule shows for a handful of services:

HCBS ServicePublished 2026 AmountUnit
Self-directed chore$4.0015 minutes
Self-directed companion$4.0015 minutes
Self-directed personal assistance$17.40Hour
Nurse-delegated personal assistance$22.72Hour
Adult day health$43.61Half day
Adult day health$87.21Day
Home-delivered meal$10.50Meal
Attendant care$23.3415 minutes
Home health aide/CNA$12.1715 minutes
RN home nursing$23.5115 minutes
LPN home nursing$15.0015 minutes
Case management$14.60Day

Worth repeating: these are 2026 figures, not locked-in 2027 rates. Check the current Med-QUEST schedule before you bill against them or build a revenue forecast around them.

Neighbor Island HCBS Rates

Geography plays into this too. For certain residential care services, Med-QUEST’s HCBS guidance builds in a neighbor-island differential — CCFFH and E-ARCH rates, for instance, include an additional amount for qualifying neighbor-island services.

If you’re providing services on Maui, Hawaii Island, Kauai, Molokai, or Lanai rather than Oahu, check whether that differential applies to you.

Hawaii Medicaid Nursing Facility Rates

No statewide CPT-style number covers nursing facility reimbursement. Med-QUEST breaks this out across several areas:

  • Nursing facility rates
  • Nursing facility acuity
  • Acute PPS rates
  • Critical Access Hospital rates
  • Hospice nursing-facility rates
  • Facility-specific reimbursement

For FY2027, pull the applicable rate memorandum and confirm the facility-specific effective period. Don’t use a reimbursement figure for financial planning until you’ve done that.

Hawaii Medicaid Hospice Rates

Hospice comes with its own payment rules, layered on top of everything else. Med-QUEST published QI-2615 for Medicaid FFS hospice inpatient nursing-facility rates, effective beginning July 1, 2026.

Some earlier Med-QUEST guidance used a formula of 95% of the applicable nursing-facility Medicaid FFS rate for certain hospice providers contracting with Medicaid nursing facilities. That percentage isn’t something to assume still applies — hospice reimbursement shifts with the facility and rate period, so check current guidance rather than relying on an older figure.

How to Look Up a Hawaii Medicaid Reimbursement Rate

Need the payment amount for a specific service? Here’s the process.

1. Find the Correct Code

  • CPT code
  • HCPCS code
  • CDT dental code
  • Revenue code
  • APR-DRG
  • HCBS procedure code

2. Identify the Provider Type

Is the service billed by a physician, therapist, dentist, FQHC, RHC, hospital, nursing facility, hospice provider, home health provider, HCBS provider, or another eligible provider type?

3. Determine the Payment Method

  • FFS: Use the applicable Med-QUEST fee schedule or rate memo.
  • QUEST Integration: Check the applicable health plan contract.
  • Hospital inpatient: Determine whether APR-DRG applies.
  • FQHC/RHC: Check PPS reimbursement.
  • HCBS: Check the current HCBS rate and modifiers.
  • Dental: Use the current dental fee schedule.

4. Check the Effective Date

Never mix an older 2025 or 2026 rate into a FY2027 calculation. Seems obvious, but it happens constantly.

5. Check Modifiers and Coverage

Modifiers can shift the reimbursement amount. And a $0.00 entry on the fee schedule doesn’t automatically mean the procedure isn’t covered — verify coverage, authorization, and payment separately through the applicable Medicaid or QUEST Integration resources.

If your patient’s eligibility status is also in question, it’s worth reviewing the Hawaii Medicaid income limits to confirm coverage before you get deep into rate calculations.

Common Hawaii Medicaid Billing Mistakes

Using an outdated fee schedule. Rates shift the moment a new schedule or provider memo goes into effect.

Assuming every claim is FFS. QUEST Integration managed-care payments can differ significantly from state FFS rates.

Ignoring modifiers. The base procedure code rarely tells the whole payment story.

Assuming Medicaid equals Medicare. Medicare-related methodology doesn’t mean matching payment.

Using one statewide reimbursement number. Hawaii runs different methodologies for professional services, hospitals, dental care, FQHCs, RHCs, HCBS, nursing facilities, and hospice — pick the wrong one and your numbers are off before you start.

Ignoring geographic differences. Neighbor-island or facility-specific differentials are easy to miss if you’re not looking for them.

Hawaii Medicaid Provider Rate Checklist

  • Correct CPT, HCPCS or CDT code
  • Correct provider type
  • Correct modifier
  • Correct place of service
  • Current FY2027 rate
  • FFS versus MCO payment method
  • Authorization requirements
  • Current Med-QUEST provider memo
  • Applicable island or facility differential
  • PPS or APR-DRG rules
  • Current dental or HCBS schedule
  • Current managed-care contract, when applicable

FAQs About Hawaii Medicaid Reimbursement Rates

What are Hawaii Medicaid reimbursement rates for 2027?

There’s no single rate. Payment depends on the service, procedure code, provider type, and payment methodology — FY2027 rates generally begin July 1, 2026.

When does Hawaii Medicaid FY2027 start?

July 1, 2026, running through June 30, 2027.

Where can I find the Hawaii Medicaid fee schedule?

Med-QUEST’s fee-schedule resources cover FFS rates and related payment information. Some services have separate schedules or provider memoranda on top of that.

Does Hawaii Medicaid use APR-DRG?

Yes, for applicable Medicaid FFS inpatient hospital services. The methodology has applied to admissions since July 1, 2022.

Does Hawaii Medicaid pay the same as Medicare?

Not necessarily. Hawaii uses Medicare-related benchmarks for some services, but Medicaid has its own payment rules and specialized methodologies layered on top.

Are QUEST Integration rates the same as FFS rates?

No — not necessarily. Managed care organizations negotiate their own provider contracts, which can differ from state FFS rates.

Does Hawaii Medicaid have separate dental rates?

Yes. Med-QUEST publishes a distinct dental fee schedule and dental provider resources, separate from the general FFS schedule.

Are FQHC and RHC reimbursement rates different?

Often, yes. They can fall under PPS methodologies with separate provider-specific rate information.

Are HCBS rates the same across Hawaii?

Not always. Some HCBS services carry geographic or neighbor-island differentials.

Does a $0 Medicaid fee mean a service is not covered?

No. A $0.00 entry doesn’t automatically mean exclusion. Verify coverage and payment through the applicable Medicaid or managed-care resources directly.

Conclusion

If you take one thing away from this: stop looking for a single Hawaii Medicaid number and start looking for the right pathway. The code, the provider type, the payment system — that combination decides what you actually get paid, not a flat statewide figure.

For FY2027, start with the current Med-QUEST fee schedule and whatever provider memo applies to your situation. Figure out whether FFS, QUEST Integration, APR-DRG, PPS, HCBS, dental, or hospice rules govern your claim, then verify the effective date before you bill or forecast anything against it. That last step is the one people skip, and it’s the one that costs them.

Official Resources

Disclaimer: Rates and payment policies can change. The information above is for general educational purposes and should be verified against the latest official Hawaii Med-QUEST guidance before billing, contracting, or financial planning.

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