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Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID)

Guidance for Medicare providers giving basic information about being certified as a Medicare and/or Medicaid Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) provider and includes links to applicable laws, regulations, and compliance information.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 22, 2016

This page provides basic information about being certified as a Medicare and/or Medicaid Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) provider and includes links to applicable laws, regulations, and compliance information.

The ICF/IID benefit is an optional Medicaid benefit.  The Social Security Act created this benefit to fund "institutions" (4 or more beds) for individuals with intellectual disabilities, and specifies that these institutions must provide "active treatment," as defined by the Secretary. Currently, all 50 States have at least one ICF/IID facility. This program serves over 100,000 individuals with intellectual disabilities and other related conditions. Most have other disabilities as well as intellectual disabilities. Many of the individuals are non-ambulatory, have seizure disorders, behavior problems, mental illness, visual or hearing impairments, or a combination of the above. All must qualify for Medicaid assistance financially.

Since the implementation of the current regulations in 1988, there has been a major shift in thinking in the field of developmental disabilities.  Emphasis is now on people living in their own homes, controlling their own lives and being an integral part of their home community. CMS recognized that the current 1988 ICF/IID regulations and survey process needed to be updated and therefore, undertook several major tasks in this program. This web site includes current CMS initiatives for the ICF/IID program.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.