Virginia pays for ramps, grab bars, wider doorways and bathroom modifications through Medicaid, and the number you will see everywhere is $5,000 per calendar year. That number is correct. What almost nobody explains is the sentence attached to it in the regulation: the cap applies regardless of waiver. Virginia does not give you one $5,000 allowance per program. It gives you one $5,000 allowance, period, and moving between waiver programs does not reset it.
That single clause changes how you should plan the work. It also turns out there are two other pots of money in the same waiver that most families never hear about, and they do not come out of the $5,000. This page walks through all of it, quoting the Virginia Administrative Code directly, and it tells you which parts Virginia has not published.
The amount and the period
Virginia runs two separate tracks of Medicaid home and community-based waivers, and both cap environmental modifications at the same figure.
For the CCC Plus Waiver (the track for older adults, people with physical disabilities, and people who are chronically ill or technology-dependent), 12VAC30-120-945 B.4.b says:
“All EM services provided in the CCC Plus Waiver shall be reimbursed as a service limit of one and up to a per member annual maximum of $5,000 per calendar year regardless of waiver. These limits shall apply regardless of whether the individual remains in this waiver or changes to another waiver program. All EM services shall be reimbursed at the actual cost of material and labor and no mark ups shall be permitted.”
For the three developmental disability waivers — Building Independence (BI), Family and Individual Supports (FIS), and Community Living (CL) — 12VAC30-122-370 C.2 says the same thing in different words:
“The maximum funded expenditure per individual for all EM service covered procedure codes (i.e., combined total of EM service items and labor related to these items) shall be $5,000 per calendar year for individuals regardless of the waiver for which EM service is approved and regardless of whether or not the individual changes waivers over the course of the calendar year.”
Three things follow from the way that is written, and they are the practical core of this page.
First, it is a calendar-year cap, not a project cap and not a lifetime cap. On January 1 it refills. Virginia is unusual here. Several states run a lifetime ceiling that, once you hit it, is gone forever. Virginia does not. A family that needs a ramp this year and a bathroom next year can legitimately plan two authorizations.
Second, unspent money does not roll over. The DD waiver regulation is explicit: EM “shall be service authorized by the state-designated agency or its designee for each calendar year with no carry-over of authorized unspent funds across calendar years.” If you get $5,000 authorized in October and the contractor finishes $3,100 of work by December 31, the remaining $1,900 evaporates. It does not become next year’s $6,900.
Third — and this is the part page after page gets wrong — the $5,000 is shared across the whole waiver system. Both regulations say “regardless of waiver.” Someone who uses $5,000 of EM in the CL waiver in March and transfers to CCC Plus in August has nothing left for the rest of that calendar year. The cap follows the person, not the program.
The two other pots of money, which do not come out of the $5,000
This is the most useful thing on this page, and it is the reason a $5,000 state can be a better state to be in than a $10,000 one.
Assistive technology has its own, separate $5,000. 12VAC30-120-945 B.4.a: “All AT services provided in the CCC Plus Waiver shall be reimbursed as a service limit of one and up to a per member annual maximum of $5,000 per calendar year regardless of waiver.” The DMAS CCC Plus Waiver Fact Sheet lists them as two separate lines — “EM – Up to $5,000 per individual per calendar year” and “AT – Up to $5,000 per individual per calendar year.”
The boundary between the two matters. Environmental modification means things attached to the house: a non-portable ramp, grab bars, a widened doorway, a bathroom rebuild, specialized electrical and plumbing to run medical equipment. Assistive technology means equipment and devices that serve the person. A shower chair, a transfer device, an item that travels with you — those are AT. The same bathroom project can often be split across both codes, and that is a legitimate conversation to have with a care coordinator rather than a trick.
Transition services are a third pot, and they are lifetime, not annual. 12VAC30-120-945 B.3: “The total costs of these transition services shall be limited to $5,000 per waiver individual per lifetime and shall be expended within nine months from the start date of authorization.” This money exists for people moving out of a nursing facility and back into the community. The nine-month clock is a real constraint — it starts at authorization, not at move-in, and it is the single most common way this benefit gets lost.
So a Virginian coming home from a nursing facility can, in principle, have $5,000 of EM, $5,000 of AT, and $5,000 of transition money in play at once. Virginia’s headline number looks small. Its actual capacity does not.
What Virginia covers
The CCC Plus regulation describes environmental modifications as adaptations documented in the plan of care, which “may include the installation of nonportable ramps and grab-bars, widening of doorways, modification of bathroom facilities, or installation of specialized electrical and plumbing systems that are necessary to accommodate the medical equipment and supplies” the person needs.
Three specifics worth knowing:
- Generators are covered in one narrow case. The regulation names “a generator for a waiver individual who is dependent on mechanical ventilation for 24 hours a day and when the generator is used to support the medical equipment and supplies necessary for the individual.” If that describes your household, ask by name. It is not a general home-hardening benefit.
- Vehicle modifications are in scope. Modifications may be made to a vehicle if it is the primary vehicle used by the person. Purchase or lease of a vehicle is not covered, and neither are general repairs. But repairs of modifications DMAS already paid for are covered.
- Everything must be done “in the least expensive manner” that achieves the goal. This phrase appears in both chapters and it is the standard the service authorization contractor applies.
What Virginia excludes, in the state’s own words
The exclusion list is long and unusually specific, which is good news — it means fewer surprises.
- General-utility improvements. Excluded are adaptations “of general utility and are not of direct medical or remedial benefit,” named in the regulation as carpeting; flooring; roof repairs; central air conditioning, and decks.
- Square footage. Adaptations that add to the total square footage of the home are excluded — except when necessary to complete an authorized adaptation, as determined by DMAS or its agent. That exception is real and worth invoking if a compliant bathroom genuinely cannot fit inside the existing footprint.
- Substandard housing. “Modifications shall not be used to bring a substandard dwelling up to minimum habitation standards.” Medicaid is not a home repair program.
- Caregiver convenience or restraint. EM “shall not be approved for purposes of convenience of the caregiver or provider or restraint.”
- Duplicates within the same residence. The regulation bars duplicate EM in one residence — it names “multiple nonportable wheelchair ramps or previous modifications to the same room.” And under 12VAC30-120-945 C.3, DMAS payments for EM “shall not be duplicative in homes where multiple waiver individuals reside.” Two waiver members under one roof do not get two ramps.
- Recreational and educational items. Named exclusions include swing sets, playhouses, climbing walls, trampolines and protective matting.
- Anything another law already requires. This one is distinctive. Virginia will not pay if the modification “can be made through the Fair Housing Act, the Virginia Fair Housing Law, or the Americans with Disabilities Act.” The DD chapter repeats it and adds the Rehabilitation Act and the Virginians with Disabilities Act.
- Anything Medicaid already covers elsewhere. EM does not pay for items obtainable as durable medical equipment. Private insurance must be exhausted first; Medicaid is payer of last resort.
If you rent in Virginia
Yes, with conditions — and Virginia’s rental rule has a second half that most states do not have.
The CCC Plus regulation requires that modifications to rental properties “shall have prior written approval of the property’s owner.” That part is standard. Then it adds: modifications to rental properties “shall only be valid if it is an independently operated rental facility with no direct or indirect ties to any other Medicaid service provider.”
In plain terms: if your landlord is also, or is connected to, a Medicaid service provider, the modification is not payable — the theory being that such a setting is already obligated to be accessible. The DD chapter states the same principle more bluntly: modifications “shall not be service authorized or covered to adapt living arrangements that are owned or leased by providers of waiver services,” because “provider-owned or leased settings where residential support service is furnished shall already be compliant with the Americans with Disabilities Act.”
Get the owner’s approval in writing before any work is scheduled, and be prepared to say who owns the building. Compare this with New Jersey, where renters face three conditions including a guaranteed one-year lease renewal.
Who does the work
Under the DD waivers the answer is narrow: an EM provider must be either a Medicaid-enrolled durable medical equipment provider or a CSB/BHA, must hold a current signed participation agreement with DMAS, must bill DMAS directly, and must perform all servicing and repairs the modification later needs. Providers “shall not be the spouse, parents, or legal guardians” of the person enrolled.
All work must comply with applicable state and local building codes, with permits and inspections provided. And the provider must have everything “delivered, installed, and in good working order” before seeking reimbursement.
DMAS publishes a list of Environmental Modification and Assistive Technology providers for fee-for-service members on the CCC Plus Waiver page. If you are in a managed care plan instead, the route is your MCO care coordinator, not the list.
Prior authorization is not optional
EM “shall be authorized by DMAS or the DMAS-designated service authorization contractor prior to billing or providing services.” Work started before authorization is work you own. This is the single most expensive mistake families make, in Virginia and everywhere else.
Qualifying: the screening comes first
Virginia separates the two halves of eligibility, and you generally need both.
The functional half is the LTSS screening. DMAS instructs that an individual “may request a LTSS Screening through their local Dept. of Social Services. A Community Based Screening Team (i.e.: Social Worker and Health Dept. Nurse), will meet with the individual and a family member/caregiver, if available.” If the person is in the hospital, a discharge planner can do the screening there.
The CCC Plus Fact Sheet lists the criteria: meet nursing-facility level of care, or be dependent on technological support requiring substantial ongoing skilled nursing care; be at imminent risk of nursing facility placement; and have waiver services be the critical services that let the person stay home rather than be placed in a facility. Health, safety and welfare must be safely maintainable at home when the aide or nurse is not present.
The financial half is a Medicaid application. Three routes, per DMAS: apply online at CommonHelp.virginia.gov; call the Cover Virginia Call Center at 1-833-522-5582 (TDD 1-888-221-1590) to apply by phone; or contact your local Department of Social Services for a paper application — and specifically request Appendix D, which is the long-term services and supports addendum. Asking for Appendix D by name will save you a round trip.
For the DD waivers the entry point is different: contact your local Community Services Board.
What Virginia has not published
Virginia states the LTSS income rule as a formula rather than a dollar figure. The DMAS one-pager says: “The countable income limit for people needing LTSS services is 300% of the Supplemental Security Income (SSI) amount for an individual.” It adds that people over the limit may still qualify “if the private cost of long-term care is greater than their income.”
We did not find a 2026 dollar amount, or a 2026 countable-resource figure, stated on any Virginia state source we checked (the CoverVA LTSS page and its one-pager PDF, the DMAS CCC Plus Waiver page, and the 2025 CCC Plus Waiver Fact Sheet). Rather than print a number we cannot source to the Commonwealth, we are recording it as not published in those documents — ask your eligibility worker at the local DSS for the current figure, since it changes with the annual SSI adjustment.
One thing Virginia does state plainly: people receiving LTSS “must contribute some of their countable income toward the cost of care,” called the patient pay. Allowances exist for basic needs and for supporting a spouse or child in the community. People who receive SSI and have no other income “do not have to contribute toward the cost of care.”
Is there a waiting list?
This is where Virginia splits sharply in two, and it is the difference between waiting a few weeks and waiting years.
CCC Plus: no waiting list. CoverVA states it directly: the CCC Plus Waiver “serves all ages and does not have a waiting list.” For an older adult or an adult with a physical disability who needs a ramp, this is the headline. There is no queue to join. The delay is the screening and the eligibility determination, not a slot.
DD waivers: a substantial waiting list. CoverVA: “This program does have a waiting list, and the slots are allocated based on urgency of need.” DBHDS put numbers on it in a January 2026 report: as of November 25, 2025, there were 19,924 individuals assigned a waiver slot (11,704 Community Living, 7,412 Family and Individual Supports, 268 Building Independence), and the total wait list was 14,258, of which 2,727 were priority one.
The same report notes 1,720 new slots funded in FY 2025 and another 1,720 in FY 2026, bringing the total to 21,479 by the end of FY 2026. It also notes that DBHDS runs an Individual and Family Support Program for families on the DD waiting list: in FY 2025 it received 5,198 applications, funded 3,807 of them, and awarded $2,499,959 in total. If you are on the DD waiting list, that program is the thing to ask your CSB about while you wait.
So if a Virginian needs a home modification and is eligible for both tracks, the practical answer is usually CCC Plus — not because it pays more, but because it pays sooner.
Frequently asked questions
How much will Virginia Medicaid pay for a wheelchair ramp?
Up to $5,000 per calendar year for all environmental modifications combined, reimbursed at the actual cost of materials and labor with no markups permitted. A ramp is explicitly named in the regulation as a covered modification, provided it is non-portable and documented in the plan of care.
Does the $5,000 reset every year?
Yes. It is a calendar-year maximum, so it refills on January 1. But unspent money from an authorization does not carry over — the DD waiver regulation says so in as many words, and both programs treat the authorization as belonging to the calendar year in which it was issued.
Can I get $5,000 from CCC Plus and another $5,000 from a DD waiver?
No. Both regulations cap EM at $5,000 per calendar year “regardless of waiver,” and both say the limit applies even if the person changes waiver programs mid-year. It is one allowance attached to the person.
Is assistive technology counted against the home modification limit?
No. AT has its own $5,000 per calendar year maximum in the CCC Plus Waiver, listed separately from EM on the DMAS fact sheet. Equipment that serves the person is generally AT; adaptations attached to the dwelling are generally EM.
I am moving home from a nursing facility. Is there extra money?
Yes — transition services, limited to $5,000 per waiver individual per lifetime, and they must be spent within nine months from the start date of authorization. That is a separate pot from the annual EM and AT maximums.
Will Medicaid widen my doorways if I rent?
Possibly. You need prior written approval from the property owner, and the rental must be an independently operated facility with no direct or indirect ties to any other Medicaid service provider. Provider-owned or provider-leased housing is excluded, on the theory that it is already required to be accessible.
How long is the wait in Virginia?
For CCC Plus there is no waiting list at all. For the three DD waivers there is: 14,258 people as of November 25, 2025, with 2,727 in priority one, and slots allocated by urgency of need rather than by date of application.
Primary sources and last verification date
Everything above was read word for word from Commonwealth of Virginia sources on September 23, 2026. No figure on this page comes from a secondary site.
- 12VAC30-120-945, Payment for covered services — the CCC Plus $5,000 EM and AT maximums and the $5,000 lifetime transition limit. Historical note: derived eff. February 12, 2015; amended eff. June 19, 2024. This is the current text.
- 12VAC30-120-924, Covered services; limits on covered services — the CCC Plus EM service description, the exclusion list, the rental-property conditions and the prior-authorization requirement.
- 12VAC30-122-370, Environmental modifications service — the DD waiver version. Derived eff. March 31, 2021.
- DMAS CCC Plus Waiver Fact Sheet 2025 — the service limitation list showing EM and AT as separate $5,000 lines.
- DMAS CCC Plus Waiver page — the screening and application instructions, and the EM/AT provider lists.
- CoverVA, Long-Term Services & Supports — the statement that CCC Plus has no waiting list and the DD waivers do.
- DBHDS, Developmental Disability Waivers (January 2026) — slot counts, the 14,258 waiting list figure and the priority one count, current as of November 25, 2025.
What we could not verify: a 2026 dollar figure for the 300%-of-SSI income limit, and a 2026 countable-resource limit, on any Virginia state source. Checked: the CoverVA LTSS page, the CoverVA LTSS one-pager PDF, the DMAS CCC Plus Waiver page and the 2025 CCC Plus Waiver Fact Sheet.
How Virginia compares
Against the other states we have documented, Virginia’s $5,000 sits in the middle of the pack by headline number and near the top by usability.
- Virginia is annual and renewable, where several states run a lifetime ceiling. Over five years, a Virginian with a recurring need has a structurally larger budget than the headline suggests.
- Virginia’s cap is hard. There is no clause permitting the payer to exceed it for cost-effectiveness. New Jersey’s $5,000 per year / $10,000 lifetime limit can be exceeded by the MCO when documented in the plan of care. Virginia’s regulation contains no equivalent. A $5,000 annual cap that never bends is a different instrument from a $5,000 annual cap that does.
- Virginia is one of the clearest states on “no waiting list” for the aged-and-disabled track, and among the most transparent about the size of the queue on the DD track.
The full picture is in our 50-state table of Medicaid home modification limits, which shows each state’s amount, period and primary source side by side. For the federal-level rules that sit underneath all of this, see does Medicaid pay for home modifications.
What to do this week
- Call your local Department of Social Services and request an LTSS Screening. This is the step that gates everything else, and it is free.
- If you are applying for Medicaid at the same time, ask for Appendix D by name. Or apply at CommonHelp.virginia.gov, or call Cover Virginia at 1-833-522-5582.
- Ask your care coordinator to price the project across EM and AT separately. Two $5,000 maximums are not the same as one $10,000 maximum, but they are much better than one $5,000 maximum, and the split is legitimate when the items genuinely fall on different sides of the line.
- If someone in the household is coming home from a nursing facility, ask about transition services immediately — the nine-month clock starts at authorization.
- Do not let anyone start work before service authorization. Not the contractor, not the family, not “we’ll sort the paperwork after.”
- If you rent, get the owner’s written approval first, and find out whether the building has any tie to a Medicaid service provider.
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