Laurie Gill
Cabinet Secretary

DSS Mobile Logo Mobile Menu Button

Health Homes - Per Member Per Month (PMPM)

Health Homes are paid on a Per Member Per Month (PMPM) basis for providing the 6 core services. The payment is made on a retrospective basis every quarter for each recipient who is provided a core service during the quarter.  Each recipient is placed in one of 4 Tiers using the Chronic Illness and Disability Payment System (CDPS). Each Tier for each type of Health Home has a different PMPM payment as outlined below.

CMHC Health Homes
Tier 1 – 10.63
Tier 2 – 38.95
Tier 3 – 56.65
Tier 4 – 188.84

PCP Health Homes
Tier 1 – 10.63
Tier 2 – 34.23
Tier 3 – 57.83
Tier 4 – 295.06

Health Home services will be provided by Community Mental Health Centers (CMHC) and Primary Care Providers (PCP).  The agency’s rates were set on April 1, 2019, and are effective for services on or after that date. The state developed fee schedules are the same for both governmental and private providers.