If you or your family member is on Medicaid in New York and needs a ramp, grab bars, or a widened doorway, one waiver covers the cost. The New York State Department of Health (NYSDOH) runs the Nursing Home Transition and Diversion (NHTD) Waiver. It funds Environmental Modifications, known as E-mods, for people who would otherwise need nursing-facility level care. A parallel Traumatic Brain Injury (TBI) Waiver covers similar modifications for brain injury survivors.
What New York offers#
NYSDOH administers the NHTD Waiver under Section 1915(c) of the Social Security Act. It serves adults age 18 to 64 with a verified physical disability, and adults 65 or older at the time of application, who need nursing-facility level care. That level of need is measured with a Uniform Assessment System for New York (UAS-NY) score of 5.
NHTD lists E-mods as a covered service. E-mods are internal and external physical changes to a home needed to protect the participant's health and welfare. Covered work includes ramps, widened doorways, roll-in showers, and vehicle modifications. E-mods are available in owned homes and in rental units, with landlord permission. The program cannot fund work that adds square footage, and it excludes improvements not tied to medical necessity, such as new carpeting, roof repair, or central air conditioning.
The TBI Waiver runs alongside NHTD with its own separate E-mods benefit for people recovering from traumatic brain injury. If brain injury is the primary diagnosis, ask your care coordinator which waiver fits your situation.
Amounts and eligibility#
NYSDOH publishes a clear dollar figure for this benefit, which is unusual among state Medicaid programs. E-mods, including vehicle modifications, are capped at $45,000 per 36-month period. Any request of $15,000 or more needs prior approval from NYSDOH before work begins. Verified against the NHTD program manual and NYSDOH training materials, July 2026.
Financial eligibility requires Medicaid coverage that supports community-based long-term care at the time of application. NYSDOH does not publish a specific income or asset dollar figure on its NHTD participant pages. Your local Department of Social Services, called the Human Resources Administration in New York City, determines financial eligibility case by case. Contact your local Department of Social Services for the exact figures that apply to your household.
The NHTD Waiver has no formal public waitlist, but it does have an approved participant cap. NYSDOH set that cap at 9,400 participants for waiver years 2025-26 through 2027-28. Enrollment can pause if the program reaches that cap, so ask your Regional Resource Development Specialist about current availability when you apply.
Only NYSDOH and your local Department of Social Services decide whether you qualify. Nothing here guarantees eligibility or approval.
How to apply in New York#
Apply through the Regional Resource Development Center (RRDC) that covers your county. Each RRDC has a Regional Resource Development Specialist (RRDS) who serves as your main contact. Find your regional office on the NYSDOH website before you start.
Your application packet includes an Initial Service Plan, built together with a Service Coordinator. That plan documents your needs and lays out which services, including E-mods, the waiver will cover. NHTD is a fee-for-service waiver, not delivered through managed care plans, so NYSDOH and your Service Coordinator authorize services directly rather than a health plan.
E-mod work itself must be completed by NYSDOH-approved providers and documented in your Service Plan. Get your provider named and your project scope approved before construction starts, especially for any request at or above $15,000.
For general help finding your local aging services office, contact NY Connects, New York's No Wrong Door system, at 1-800-342-9871, or visit aging.ny.gov. The federal Eldercare Locator (eldercare.acl.gov, 1-800-677-1116) is a fallback if you need help outside New York.
How it stacks with federal programs#
If the person needing modifications is a veteran, check VA housing grants alongside the NHTD Waiver. Programs like Specially Adapted Housing (SAH) can fund larger projects and may work alongside Medicaid coverage. See our VA home modification grants guide.
Original Medicare does not cover structural home modifications. Some Medicare Advantage (Part C) plans offer supplemental benefits like grab bars or ramps, but this is plan-specific with no standard amount. Call your plan to ask what it covers.
Finding a provider who knows this program: Not every contractor has handled NHTD E-mod paperwork. Adapta Home USA verifies providers' Medicaid Waiver Billing experience, so you can filter for pros in New York who have done this before. Find Home Modifications & Remodeling providers with Medicaid Waiver Billing experience →
For the bigger picture on combining programs, see our national Medicaid waiver guide and our full guide to paying for home modifications.
FAQ#
Does New York Medicaid pay for home modifications like ramps or stair glides?#
Yes. The NHTD Waiver covers Environmental Modifications, including ramps, grab bars, widened doorways, and vehicle modifications, for people who qualify for waiver services and need nursing-facility level care.
How much can the NHTD waiver pay toward home modifications?#
E-mods are capped at $45,000 per 36-month period, which includes vehicle modifications. Requests of $15,000 or more require prior approval from NYSDOH before work starts.
Can renters get home modifications through the NHTD waiver?#
Yes. E-mods are available in rental units as well as owned homes, as long as the landlord gives permission for the work. The modification cannot add square footage to the unit.
How do I apply for the NHTD waiver in New York?#
Contact the Regional Resource Development Center (RRDC) for your county and work with a Regional Resource Development Specialist (RRDS). Your application includes an Initial Service Plan built with a Service Coordinator.
Find a verified provider near you#
Adapta Home USA's directory lets you search Home Modifications & Remodeling providers in New York and filter for Medicaid Waiver Billing experience. Our wheelchair ramp cost guide and accessible bathroom remodel cost guide can help you budget while your application is in progress.
This article is for general educational purposes only and does not constitute medical, legal, or financial advice. Consult a qualified professional about your specific situation.
Program amounts, eligibility rules, and application procedures change. Figures on this page were verified against official government sources on the date shown, but you should confirm current details at VA.gov or with the administering agency before making decisions. Adapta Home USA is not affiliated with the U.S. Department of Veterans Affairs or any government agency.