2021 State Directed HCBS Rate Increase – Impacted Service Codes
Family Care HCBS Inclusion Logic
SPCs Covered
102.00 | Adult Day Care |
110.00 | Daily Living Skills Training |
706.00 | Day Habilitation Services |
202.11 | AFH 1-2 bed (care&supervision) |
202.22 | AFH 3-4 bed (care&supervision) |
506.71 | CBRF- 5-8 bed (care&supervision) |
506.76 | CBRF- greater than 8 beds (care&supervision) |
711.02 | RCAC- (care&supervision) daily |
103.99 | Respite Care |
104.00 | Supportive Homecare – Daily |
104.20 | Supportive Homecare |
104.30 | Supportive Homecare |
Procedure Codes Not Covered
S5120 | Chore Services, per 15 min |
S5121 | Chore Services, per day |
Covered Supported Employment Codes
108.10 | Prevocational Services |
114.00 | Vocational Futures Planning & Support |
615.00 | Supported Employment |
615.10 | Supported Employment- Integrated |
Procedure Codes:
H2025 | Supported employment, ongoing coaching |
T2014 | Community based prevocational services |
T2015 | Community based prevocational services |
T2018 | Integrated: 1-2 Members |
T2019 | Integrated: 1-2 Members |
T2038 HJ | Voc Futures Planning |
Family Care Partnership HCBS Inclusion Logic
Procedure Codes Not Covered: A0000 through R9999
Revenue Codes Not Covered: 0550 through 0559
Procedure Codes Covered
99509 | RN Supervisory visit for personal care |
99600 | Skilled Nursing services |
H2014 | Daily Living Skills Training |
S5100 | Day care services, adult; per 15 minutes |
S5101 | Day care services, adult; per half day |
S5102 | Day care services, adult; per diem |
S5105 | Adult day care: SERVICE NOT INCLUDED IN PROGRAM FEE, per diem |
S5125 | Attendant Care, per 15 mins |
S5126 | Attendant Care, per day |
S5130 | SHC-Routine Health Care Service |
S5136 | Supportive Home Care – per day: Community Supported Living |
S9125 | Respite care-institutional setting, per diem |
T1005 | Respite care in the home, per 15 minutes |
T2012 | Daily Living Skills; per day |
T2013 | Daily Living Skills per hour |
T2021 | Day Services; per 15 minutes |
S5135 | Companion Care; per 15 min |
T2020 | Community-Based Day Services, per day |
Revenue Codes Covered
0220 | AFH bedhold ancillary residential care services only; per day |
0229 | CBRF bedhold ancillary residential care services only, day |
0240 | AFH- 1-2 bed C/S |
0241 | AFH- 3-4 Bed C/S |
0242 | CBRF < 8 bed C/S |
0243 | CBRF > 8 bed C/S |
0670 | RCAC- C/S |
0672 | SHC- C/S |
Supported Employment Codes Covered
H2025 | Supp Employ Coaching, hour |
T2014 | Prevocational services; per diem |
T2015 | Prevocational services; per hour |
T2018 | Supported Employment |
T2019 | Supported Employment |
T2038 HJ | Voc Futures Planning |