How States Pay for Remote Support
By Precious Myers-Brown, CEO and founder. Last checked October 25, 2026.
Any provider agency, in any state or anywhere in the world, can buy Vista Enterprise™ the way it buys an EHR or payroll system, with no state approval. This map covers something different: how each state pays for remote support and technology, who bills, and where the official rules live. The first wave covers DC, Maryland, Virginia, New Jersey, Delaware and Pennsylvania, and Ohio, Tennessee, Minnesota, Missouri, Indiana, Wisconsin, New York, Colorado, Kentucky and Washington are now on the map too.
Buying is not billing
Two questions often get mixed up. The first is whether your agency can get a remote support solution. The answer is yes, in every state, and it needs no approval from a state agency, a managed care plan, or anyone else. The second is whether a state program will pay for remote support for a person supported. That depends on the program, the service, your agency’s provider status, and each person’s plan. This map answers the second question, state by state. With Vista Enterprise™, your agency keeps its remote support billing. That is the heart of Precious Myers-Brown’s Provider Capacity-Building Model: Stabilization, Capacity Building, Independence.
Three ways states pay for remote support
- Per person, in the plan. A waiver lists a remote support service or a technology service, the person’s team writes it into their plan, and a qualified provider bills it.
- Inside a service the agency already bills. Some states fold remote support into a residential or day service, so it is part of that rate rather than a separate line.
- From the agency’s own budget. An agency pays for its remote support solution as an operating cost, the way it pays for its EHR. This works in every state and every setting, including ICFs, nursing homes, assisted living and home care.
Most agencies use more than one of these at the same time.
The map at a glance
| State | What the state calls it | How it is usually paid | Who bills |
|---|---|---|---|
| District of Columbia | Remote supports versions of five DDS waiver services, plus the Assistive Technology service (AT) | Per person, in 15-minute units, under each service; equipment through AT | The DDS-certified provider of that service |
| Maryland | “Remote Support Services” in the Community Pathways Waiver | Per person, in the plan, with DDA authorization | A licensed or DDA-certified provider |
| Virginia | “Electronic Home-Based Supports” (EHBS), plus AT, in three DD waivers | Per person; EHBS and AT share one calendar-year budget | A DMAS-enrolled EHBS or AT provider |
| New Jersey | AT and personal emergency response systems (PERS) in two DDD programs; no separate remote support staffing service | Per person, from the person’s DDD budget, with prior approval | An approved AT or PERS provider |
| Delaware | “Remote Supports” in the DDDS Lifespan Waiver, new in 2026 | Per person, based on assessed need | A Lifespan Waiver provider, under the state’s rules for the service |
| Pennsylvania | “Remote Supports” and “Remote Support Technology/Equipment” in four ODP waivers | Per person in private homes; built into residential rates | A qualified provider; for residential services, the residential provider |
| Ohio | “Remote support” in the DODD Individual Options, Level One and SELF waivers, plus the assistive technology service | Per person, in the ISP, at one of two rates set by backup type; equipment through the assistive technology service | A DODD-certified agency provider with an Ohio Medicaid provider agreement |
| Tennessee | “Enabling technology” (ET) in CHOICES, ECF CHOICES and the 1915(c) waivers | Per person, through the ET benefit, by purchase or lease; MCOs can also directly acquire ET for members | An ET provider, after authorization through DDA (1915(c) waivers) or the person’s MCO (CHOICES and ECF CHOICES); MCOs can also directly acquire ET for members |
| Minnesota | Remote support as a way to deliver waiver services, plus remote overnight supervision under Minn. Stat. 245D.261 | Units of the approved service, at the same rate as in person; on the BI, CAC, CADI and DD waivers, sensors that alert staff through environmental accessibility adaptations | The provider of the service delivered remotely; for 245D.261, the licensed residential provider |
| Missouri | “Remote Supports” in four DD waivers, a standalone service since July 1, 2023 | Per person, as a waiver service that includes the equipment; plus a quality incentive for ISL and In-Home Respite providers | A Remote Supports provider in the DD waivers |
| Indiana | Remote supports in the CIH and Family Supports waivers | Per hour, divided among the waiver participants in the home; equipment built into the rate | An FSSA/DDARS Approved Remote Support provider enrolled in Medicaid |
| Wisconsin | Remote Monitoring and Support in Family Care and Family Care Partnership; remote delivery of allowable services in IRIS | Authorized by the member’s MCO in Family Care; in IRIS, devices through the AT service category | A Remote Support Service Provider in Family Care; in IRIS, the remote service provider, with devices under the AT service category |
| New York | Home-Enabling Supports (HES), including Remote Supports, in the OPWDD HCBS Waiver, for people in non-certified settings | Per person, as HES after DDRFO prior authorization, with an annual limit on acquisitions; in Self-Direction, from the person’s Personal Resource Account (PRA) | An HES Provider, the provider of record for billing, which bills eMedNY and contracts with a Remote Support Vendor |
| Colorado | Remote Supports as a Community First Choice (CFC) benefit, since July 1, 2025 | Units on HCPF’s fee schedule for installation and equipment and for the ongoing service; not paid in provider-owned, provider-controlled or congregate settings | The enrolled Remote Supports provider the member selects |
| Kentucky | Technology assisted residential services in the Supports for Community Living (SCL) waiver | As an SCL residential support service, for three or fewer participants in a residence who reduce in-home staff support | The technology assisted residential service provider |
| Washington | Remote Support, a standalone DDA waiver service in the Basic Plus, Core and IFS waivers | Service hours and equipment authorized together after prior approval; Basic Plus aggregate budget and IFS annual allocation limits apply | A DDA-contracted Remote Support provider |
Every row was checked against the state’s own documents on October 25, 2026. Rules change, so always confirm with the source before you bill.
District of Columbia
- Where it lives. The Department on Disability Services (DDS) describes remote supports versions of Day Habilitation, Employment Readiness, Supported Employment, In-Home Supports and Supported Living in its IDD and IFS waivers.
- How it is paid. Remote supports are billed per person in 15-minute units under each service. Equipment rental/purchase goes through the Assistive Technology service (AT).
- What to know. Video cameras/monitors are permitted only in common areas and will not be installed in the bathrooms or bedrooms. Supported Living remote supports can be provided in homes of one, two or three people. The support team uses the Assessing Interest in Remote Supports and Technology tool first.
- Older adults and people with physical disabilities. DC’s EPD waiver is run by the Department of Health Care Finance.
Sources, checked October 25, 2026: DDS IDD and IFS Waiver Remote Supports Services Descriptions, July 10, 2026; DDS IDD waiver rates; DHCF EPD waiver services.
Full detail: Remote support in the District of Columbia.
Maryland
- Where it lives. The Developmental Disabilities Administration (DDA) lists Remote Support Services in the Community Pathways Waiver. Since October 6, 2025, Community Pathways is DDA’s single waiver.
- How it is paid. Per person, based on assessed need, written in the plan and authorized by the DDA. The DDA expects the service to be cost-neutral compared with in-person support.
- What to know. Remote Support Services is not available to people receiving Community Living-Enhanced Supports or Shared Living. Since October 2025, the waiver’s AT and Services covers monthly service fees, and personal emergency response systems moved to Community First Choice.
Sources, checked October 25, 2026: DDA Remote Support Services; DDA Community Pathways Waiver; DDA guide to the October 2025 waiver changes.
Full detail: Remote support in Maryland.
Virginia
- Where it lives. The Department of Medical Assistance Services (DMAS) covers Electronic Home-Based Supports (EHBS) and AT in the Building Independence, Family and Individual Supports, and Community Living waivers.
- How it is paid. Per person, by service authorization, with the need written in the Individual Support Plan. Since September 1, 2025, EHBS and AT share one calendar-year budget per person, authorized by need. The regulation text online still shows an older, separate plan-year limit, so go by the DMAS bulletin and check the current limit with the person’s support coordinator.
- What to know. EHBS is for adults 18 and older and starts with an assessment by an independent professional. It is not covered for people living in group homes, sponsored residential or supported living. When an authorization includes ongoing electronic monitoring, Virginia’s rule adds extra requirements for the provider of ongoing monitoring systems.
- Older adults and people with physical disabilities. Virginia’s CCC Plus waiver covers PERS and AT through managed care.
Sources, checked October 25, 2026: DMAS bulletin on the HCBS waiver amendments, August 12, 2025; 12VAC30-122-360, Electronic Home-Based Supports.
Full detail: Remote support in Virginia.
New Jersey
- Where it lives. The Division of Developmental Disabilities (DDD) Supports Program and Community Care Program both list AT and personal emergency response systems (PERS). Neither lists a separate remote support staffing service.
- How it is paid. Per person, from the person’s individual budget, with DDD prior approval after an evaluation. The technology goes in the Individualized Service Plan.
- What to know. Because there is no separate remote support staffing service, most New Jersey residential providers that use remote support pay for it from their own budget. Older adults and people with physical disabilities can get PERS through their NJ FamilyCare managed care plan.
Sources, checked October 25, 2026: DDD Supports Program policy manual; DDD Community Care Program policy manual; NJ FamilyCare MLTSS.
Full detail: Remote support in New Jersey.
Delaware
- Where it lives. In July 2026, Delaware announced federal approval to add Remote Supports to the Lifespan Waiver run by its Division of Developmental Disabilities Services.
- How it is paid. Eligible people in the Lifespan Waiver can get the service based on their assessed needs.
Sources, checked October 25, 2026: Delaware news release, July 28, 2026.
Full detail: Remote support in Delaware.
Pennsylvania
- Where it lives. The Office of Developmental Programs (ODP) offers Remote Supports and Remote Support Technology/Equipment in its Consolidated, Community Living and Person/Family Directed Support waivers and its Adult Autism Waiver.
- How it is paid. For people in private homes, the services are authorized in the person’s ISP and billed by a qualified provider. For people in Residential Habilitation, Life Sharing or Supported Living, remote supports are part of the residential service, and shared technology is covered in the residential rate. Technology for one person can be billed per person, with the residential provider listed as the provider.
- What to know. ODP does not recommend remote supports for people under 16. A residential provider can subcontract with another company for the technology.
Sources, checked October 25, 2026: ODP service descriptions; ODP Announcement 24-015; ODP Announcement 21-090.
Full detail: Remote support in Pennsylvania.
Ohio
- Where it lives. The Ohio Department of Developmental Disabilities (DODD) covers remote support in the Individual Options, Level One and SELF waivers, under Ohio Adm.Code 5123-9-35, effective July 1, 2026.
- How it is paid. Per person, as written in the Individual Service Plan (ISP), at one rate when backup support is unpaid and another when it is paid. When several people in the same home receive it at the same time, the rate is divided equally among them. Equipment, software and monthly fees can go through the assistive technology service.
- What to know. Remote support starts with written consent from the person and each person they live with, or their guardians, and an ISP that names the backup support. It is not provided in shared living. With paid backup support, the homemaker/personal care provider has the right of first refusal to bill.
- Technology First. Ohio law makes access to innovative technology solutions state policy for people with developmental disabilities, and each county board and ICF/IID keeps a written Technology First policy.
Sources, checked October 25, 2026: Ohio Adm.Code 5123-9-35, remote support; Ohio Adm.Code 5123-9-12, assistive technology service; Ohio Revised Code 5123.025; Ohio Adm.Code 5123-2-01, Technology First.
Full detail: Remote support in Ohio.
Tennessee
- Where it lives. TennCare covers enabling technology (ET) in CHOICES, Employment and Community First (ECF) CHOICES and the 1915(c) waivers, under the TennCare ET Protocol, effective February 1, 2026. ET can cover technology systems that let a person receive remote supports.
- How it is paid. Per person, through the ET benefit, by purchase or lease. Each program sets its own benefit limit, and spending can go past it only as a cost-effective alternative. Since the February 2026 update, MCOs can directly acquire ET for members.
- What to know. People are screened for ET at enrollment and at least once a year with their Circle of Support, and the person-centered support plan (PCSP) holds a backup and emergency preparedness plan for remote supports.
Sources, checked October 25, 2026: TennCare ET Protocol, effective February 1, 2026; DDA Memo 2026-2, January 26, 2026.
Full detail: Remote support in Tennessee.
Minnesota
- Where it lives. Minnesota DHS treats remote support as a method used to deliver an allowable service in the waivers, Alternative Care and Essential Community Supports, not as a service of its own. Separately, Minn. Stat. 245D.261 lets a license holder use remote overnight supervision in a community residential setting, instead of on-site direct support staff.
- How it is paid. Units of the approved service are paid at the same rate whether they are provided in person or remotely. Remote support does not fund the technology: on the BI, CAC, CADI and DD waivers, technology or equipment that monitors the person in real time, such as sensors, is authorized through environmental accessibility adaptations. If the person cannot take the equipment with them when they move, the equipment is a provider expense.
- What to know. The person chooses remote support, and the support plan names the needs that must be met in person. Under 245D.261, each support plan addendum records the longest time allowed for someone to arrive in person, which the person’s support team sets.
Sources, checked October 25, 2026: Minnesota DHS Community-Based Services Manual, remote support; Minn. Stat. 245D.261; Minnesota DHS, Guidance on support technology and service planning.
Full detail: Remote support in Minnesota.
Missouri
- Where it lives. Missouri’s Division of Developmental Disabilities made Remote Supports a standalone service in the Comprehensive, Community Support, Partnership for Hope and Missouri Children with Developmental Disabilities (MOCDD) waivers, effective July 1, 2023.
- How it is paid. Per person, as a waiver service. It covers an initial installation fee, ongoing monthly rental charges, and upkeep and maintenance, and the equipment is part of the service. Individualized Supported Living (ISL) and In-Home Respite providers that move from paid staff support hours to remote supports can also earn a quality incentive of 15% of the general revenue savings for each six-month period, up to twice a year.
- What to know. Remote Supports technology may only be used with the full consent of the individual and their guardian, if they have one. It is not provided at the same time as ISL, Personal Assistant or Individualized Skill Development services.
Sources, checked October 25, 2026: Missouri DMH Division of DD Provider Bulletin 29; Missouri DMH Division of DD, Remote Supports value-based payment.
Full detail: Remote support in Missouri.
Indiana
- Where it lives. Remote supports are a service in the Community Integration and Habilitation (CIH) Waiver and the Family Supports Waiver, both approved effective August 1, 2026, for adults and for individuals 14 to 17 years of age.
- How it is paid. At the full unit rate for each hour of remote supports, divided among the waiver participants present in the home who have remote supports on their plan. The equipment cost is built into the rate. In the CIH Waiver, remote supports can also be part of residential habilitation and support daily (RHS Daily), and are not billed on top of it.
- What to know. Informed consent documents are signed and dated by the individual, guardian, case manager and provider agency representative, as appropriate. Both waivers say their remote supports service may not be used in ICFs/IID licensed under IC 16-28 and 410 IAC 16.2.
Sources, checked October 25, 2026: Indiana CIH Waiver, effective August 1, 2026; Indiana Family Supports Waiver, effective August 1, 2026.
Full detail: Remote support in Indiana.
Wisconsin
- Where it lives. The Family Care and Family Care Partnership waiver, renewed effective January 1, 2025, added Remote Monitoring and Support for frail elders, adults with physical disabilities, and adults with intellectual or developmental disabilities who have long-term care needs. IRIS allows remote delivery of allowable services.
- How it is paid. In Family Care, the member’s managed care organization (MCO) authorizes the service through the interdisciplinary team (IDT); it excludes internet service. In IRIS, devices and equipment for remote service delivery are covered under the AT service category.
- What to know. In Family Care, the member, their legal decision-maker and anyone living with the member consent in writing before use, and the forms are updated at least every six months. The service complements, but does not replace, in-person services.
Sources, checked October 25, 2026: Family Care and Family Care Partnership Waiver Renewal 2025; IRIS Policy and Procedure P-03081, July 2026.
Full detail: Remote support in Wisconsin.
New York
- Where it lives. OPWDD added Home-Enabling Supports (HES) as a sub-component of the Assistive Technology (AT) benefit in the OPWDD HCBS Waiver, effective October 1, 2023. HES can include AT devices, Remote Supports, and Health Assessment and Coordination Services, for people enrolled in the waiver who live in non-certified settings. Remote Supports is for ages 15 and older.
- How it is paid. Per person, after prior authorization from the Developmental Disabilities Regional Field Office (DDRFO), with an annual limit on acquisitions. The HES Provider is the provider of record for billing: it bills eMedNY and contracts with the Remote Support Vendor. HES funds cannot buy or lease cell phones, and internet service cannot be billed directly. In Self-Direction, HES costs fit in the person’s Personal Resource Account (PRA).
- What to know. HES alone does not count as the person’s monthly waiver service. Where HES affect privacy, the person, and anyone else living in the residence whose privacy is affected, gives written informed consent before HES are used. Consent can be revoked at any time. HES is not available in OPWDD certified residences; there, technology an agency adopts may be reflected in its cost reporting for later cost-based rates.
Sources, checked October 25, 2026: OPWDD ADM 2024-02, Home-Enabling Supports; OPWDD, Home-Enabling Supports for providers.
Full detail: Remote support in New York.
Colorado
- Where it lives. Remote Supports is a covered benefit for members enrolled in Community First Choice (CFC), a Health First Colorado State Plan option that started July 1, 2025, under 10 CCR 2505-10 section 8.7544.
- How it is paid. In units on HCPF’s fee schedule and billing manuals: one unit per installation or equipment purchase, plus units for the ongoing service. Internet access, phone lines and cell phone plans are not part of the benefit. Remote Supports in provider-owned, provider-controlled or congregate settings is not reimbursed by Colorado Medicaid.
- What to know. Remote Supports is approved only when it is the member’s preference and will reduce the assessed need for in-person care. The provider writes a Remote Supports Service Plan with the member, including a list of Backup Support Persons, and sends it to the Case Manager. The Backup Support Person comes in a reasonable time the team agrees on, kept in the provider’s records.
Sources, checked October 25, 2026: 10 CCR 2505-10 section 8.7544, Remote Supports; HCPF, Community First Choice.
Full detail: Remote support in Colorado.
Kentucky
- Where it lives. Technology assisted residential services are one of three residential support services in the Supports for Community Living (SCL) waiver, under 907 KAR 12:010, alongside Level I and Level II residential supports.
- How it is paid. As an SCL residential support service, furnished in a participant’s residence to three or fewer participants who reduce in-home staff support through the service.
- What to know. A real-time monitoring system links the participant’s residence to remote staff employed to provide electronic support, using a two-way method of communication. Under Kentucky’s February 2026 camera guidance, camera use for remote or virtual support is the participant’s choice, documented in the plan, and the participant may change their mind at any time.
Sources, checked October 25, 2026: 907 KAR 12:010; Kentucky DMS, Camera Technical Assistance, February 20, 2026.
Full detail: Remote support in Kentucky.
Washington
- Where it lives. Remote Support is a standalone DDA waiver service in the Basic Plus, Core and Individual and Family Services (IFS) waivers, defined in WAC 388-845-0945 and set out in DDA Policy 4.28.
- How it is paid. DDA authorizes the service hours and the equipment together, after prior approval by the regional administrator or designee. On Basic Plus, remote support is limited to the aggregate budget and emergency assistance funding, if eligible; on IFS, to the annual allocation. It does not pay for internet, data plans or wi-fi.
- What to know. Only the client may start live two-way interactions, unless their person-centered service plan says otherwise. The provider must be contracted with DDA, and a guardian, legal representative, parent or other family member cannot provide it. For clients in supported living, group training homes or group homes, Remote Support replaces supervision, coaching and consultation, and the resource manager completes a rate assessment.
Sources, checked October 25, 2026: WAC 388-845-0945; WAC 388-845-0950; WAC 388-845-0955; DDA Policy 4.28, Remote Support; DDA Policy 6.17, residential habilitation.
Full detail: Remote support in Washington.
What about ICFs, nursing homes, assisted living and home care?
These settings are usually paid as facilities or agencies, not through a person’s waiver plan, so remote support is an operating cost, the same in every state. Federal rules still set the floor: ICFs for people with intellectual disabilities keep their federal staffing requirements, and home and community-based settings must respect each person’s privacy, choice and control. Enabling technology does not replace the DSP. It protects her. And it never replaces the rules.
Questions to ask your state
- Which waiver services can be delivered remotely, and for whom?
- Is remote support a separate service, part of another service’s rate, or both?
- What assessment or plan step comes first?
- What provider credentials does billing need?
- What privacy rules apply to cameras and sensors?
What comes next on this map
By 2025, about 40 states had Technology First initiatives or legislation (The Convergence of Care, 2026), so this map keeps growing. More states are added as each row is complete and checked against the state’s own documents. Each row carries its own last-checked date. Don’t see your state? Ask us to map your state next.
Questions agencies ask about state funding
Does my agency need state approval to buy a remote support solution?
No. Any agency, in any state or anywhere in the world, can get Vista Enterprise™ the way it gets an EHR or payroll system, with no approval from a state agency or anyone else. State approval questions come up only when a state program pays for remote support for a person supported.
Is this map about buying or about billing?
Billing. It shows how each state pays for remote support and technology, who bills, and where the official rules live. Buying a remote support solution for your agency is a separate question, and the answer is the same everywhere: no approval is needed.
Why are there no prices or rates on this map?
Rates change often and differ by service, unit and region, so this map links to each state’s own rate and rule documents instead. Always confirm the current rate with the state before you bill.
How current is this map?
Every row was checked against the state’s own documents on October 25, 2026. Each row shows its last-checked date, and rows are rechecked as states publish changes.
Which states are on the map?
The map covers the District of Columbia, Maryland, Virginia, New Jersey, Delaware, Pennsylvania, Ohio, Tennessee, Minnesota, Missouri, Indiana, Wisconsin, New York, Colorado, Kentucky and Washington. More states are added as each row is complete and sourced.
Who responds when remote support is in place?
Your agency’s own trained team responds and decides, following each person’s plan. VistaLink™ never acts alone.
Can we use remote support if our state has no remote support service?
Yes. Your agency can pay for its remote support solution from its own budget, the way ICFs, nursing homes, assisted living and home care agencies do in every state. Some states also pay for technology per person through a technology service.
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