Read APPENDIX A text version

AGED AND DISABLED ADULT WAIVER PROCEDURE CODES AND FEE SCHEDULE

Code Mod. 1* U2 U2 U2 U2 Mod. 2* Service Maximum Reimbursement Per Unit

$5.25 per 15-minute unit $2.50 per 15-minute unit $10.00 per 15-minute unit $9.25 per 15-minute unit

Maximum Limit

S5135 S5100 S5125 97537

ADULT COMPANION SERVICES ADULT DAY HEALTH CARE ATTENDANT CARE SERVICES CAREGIVER TRAINING/ SUPPORT­INDIVIDUAL CAREGIVER TRAINING/ SUPPORT­GROUP CASE AIDE TS CASE MANAGEMENT CASE MANAGEMENT AGING OUT--ENHANCED TRANSITION CASE MANAGEMENT CHORE U2 CHORE­ENHANCED CONSUMABLE MEDICAL SUPPLIES U2 CONSUMABLE MEDICAL SUPPLIES­ENHANCED COUNSELING

32 units (8 hours) per day 40 units (10 hours) per day 40 units (10 hours) per day 16 units (4 hours) per day with maximum monthly total of 80 units (20 hours) per month 16 units (4 hours) per day with maximum monthly total of 80 units (20 hours) per month 16 units (4 hours) per day 32 units (8 hours) per day Flat fee per client per month. 80 units (20 hours) per six (6) month transition period ($900 maximum) 32 units (8 hours) per day 32 units (8 hours) per day No limit on number of purchases up to dollar amount No limit on number of purchases up to dollar amount 32 units (8 hours) per day with maximum monthly total of 80 units (20 hours) per month 3 installations per lifetime 31 days per month 32 units (8 hours) per day 16 units (4 hours) per day with maximum monthly total of 32 units (8 hours) per month 16 units (4 hours) per day with maximum monthly total of 64 units (16 hours) per month 2 meals per day 5 jobs per year

S5110

U2

$2.00 per 15-minute unit

G9002 G9002 T2022 T2024

U2 U2 U2 U2

$5.25 per 15-minute unit $11.25 per 15-minute unit $145.00 per month $11.25 per 15-minute unit

S5120 S5120 S5199 S5199 H0004

U2 TS U2 TS U2

$4.50 per 15-minute unit $6.50 per 15-minute unit $500.00 in total purchases per month $5,000.00 in total purchases per month $15.00 per 15-minute unit

S5160 S5161 T2001 H2011

U2 U2 U2 U2

EMERGENCY ALERT RESPONSE INSTALLATION EMERGENCY ALERT RESPONSE MAINTENANCE ESCORT FINANCIAL ASSESSMENT/ RISK REDUCTION TS FINANCIAL MAINTENANCE/ RISK REDUCTION HOME DELIVERED MEALS HOME MODIFICATIONS

$95.00 per installation $1.30 per day $5.25 per 15-minute unit $8.75 per 15-minute unit

H2011

U2

$5.00 per 15-minute unit

S5170 S5165

U2 U2

$7.00 per Home Delivered Meal unit $1,000.00 per job

*Modifiers are part of the procedure code and must be entered in the modifier fields when billing for the service.

May 2009

1

Code S5130 97802

Mod. 1* U2 U2

Mod. 2*

Service HOMEMANAGER/ HOMEMAKER NUTRITIONAL RISK REDUCTION OCCUPATIONAL THERAPY PERSONAL CARE PEST CONTROL­INITIAL VISIT PEST CONTROL­ MAINTENANCE PHYSICAL RISK REDUCTION PHYSICAL THERAPY REHABILITATION ENGINEERING EVALUATION RESPIRATORY THERAPY­ EVALUATION RESPIRATORY THERAPY­ TREATMENT RESPITE­IN-HOME RESPITE­FACILITYBASED

Reimbursement Per Unit

$4.50 per 15-minute unit $12.00 per 15-minute unit

Maximum Limit

32 units (8 hours) per day 16 units (4 hours) per day with maximum monthly total of 64 units (16 hours) per month 8 units (2 hours) per day 48 units (12 hours) per day 1 initial visit per client 1 service per month 16 units (4 hours) per day with maximum total of 64 units (40 hours) per year 16 units (4 hours) per day Number of evaluations will coincide with limits set for the assistive technologies/ adaptive equipment services 1 per day 1 per day 96 units per day (24 hours) with maximum 60 full days per year 96 units per day (24 hours) with maximum 60 full days per year 2 visits per day 2 visits per day 1 purchase per month

97530 T1019 G9004 G9005 99412 97110 T1028

U2 U2 U2 U2 U2 U2 U2

$16.69 per 15-minute unit $5.00 per 15-minute unit $65.00 $50.00 per month $6.25 per 15-minute unit

$16.69 per 15-minute unit $85.00 per evaluation

S5180 99503 S5150 T1005 T1001 T1001 E1399

U2 U2 U2 U2 U2 U2 U2 HM HN

$45.00 per evaluation $20.00 per 15-minute unit $4.50 per 15-minute unit

$2.50 per 15-minute unit

SKILLED NURSING­RN, LPN SKILLED NURSING­BSN SPECIALIZED MEDICAL EQUIPMENT AND SUPPLIES SPEECH-LANGUAGE PATHOLOGY THERAPY

$25.00 per visit. $35.00 per visit $1,000.00 per purchase

92507

U2

$10.00 per 15-minute unit

16 units (4 hours) per day

*Modifiers are part of the procedure code and must be entered in the modifier fields when billing for the service.

May 2009

2

Information

APPENDIX A

2 pages

Find more like this

Report File (DMCA)

Our content is added by our users. We aim to remove reported files within 1 working day. Please use this link to notify us:

Report this file as copyright or inappropriate

328196


You might also be interested in

BETA
4750RevCA.fm
eobcrosswalk0104.xls
Microsoft Word - WS-2316-e2.doc
QW-3071(B)
MANUAL ON CODES