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

ICF/IID is an optional Medicaid benefit that allows States to provide food, shelter, healthcare and rehabilitation services to recipients who are mentally challenged or persons with related conditions that requires services on a regular basis. Requests for ICF/IID are submitted on the MAD 378 form. ICF/IID requests must meet the established ICF/IID Level of Care (LOC). The LOC approvals are indicated on the MAD 378 form by the presence of an authorization number and LOC span.The updated MAD 378 is then returned for notification to the requesting provider.