Worksheet, Fill In Your Numbers
The 2% Rate-Cut Margin Recovery Calculator
The 2% reduction across HCBS, LTSS, and CMA rates took effect July 1. The cut is real, but for most agencies it's smaller than what they're already losing to preventable billing gaps. Fill in your numbers to see what the cut costs you, and how much margin is sitting in reach.
Section A, Your Agency Numbers
Number of active DSPs
Full-time and part-time caregivers currently on staff
Average billed hours per DSP / week
Typically 25 to 35 hours full-time, 10 to 15 part-time
Average Medicaid billing rate / hour
Use your pre-July-1 rate, the calculator applies the 2% cut for you
$
Current claim denial rate (%)
If unknown, agencies without integrated EHR billing average 8 to 12%
%
Hours lost to documentation errors / week
Unbilled hours lost to incomplete, late, or rejected documentation
Section B, What the Cut Costs You
Gross annual Medicaid billing
DSPs × hrs/week × rate × 52 weeks
$0
Annual cost of the 2% cut
Gross annual billing × 2%
$0
Section C, What You're Already Leaking
Annual denial leakage
Annual billing × current denial rate
$0
Annual documentation loss
Hours lost/week × rate × 52 weeks
$0
RECOVERABLE WITH INTEGRATED BILLING
Denials cut to 2% + 85% of documentation loss recovered
$0
Your net position after closing the leak
$0
Enter your numbers above to see whether recovering your current leakage absorbs the 2% cut, and by how much.
Why this works
The 2% cut is fixed, you can't negotiate the rate. But denials and documentation gaps are operational, and they're usually several times larger than the cut itself. Agencies running integrated, point-of-care documentation routinely pull denial rates under 2% within 60 days. That recovered margin doesn't just cover the cut, it outlasts it.
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