Inclusa Provider Partners – March 2018 6 877-622-6700 | inclusa.org ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● Claims & Billing Updates Personal Care Rate Increase As you know, effective for dates of service on and after 07/01/2017, the maximum allowable reimbursement for Personal Care services increased by two percent. This rate will increase by another two percent effective for dates of service on and after 07/01/2018. Codes affected:  T1019 – Direct personal care services  T1019 U3 – Travel time  99509 TD – Registered nurse supervisory visit Inclusa has submitted retroactive adjustments to WPS for any paid claims for dates of service on and after 01/01/2018. As communicated to you in our January letter to Personal Care providers, we will be working with WPS in April 2018 to reprocess any paid claims for dates of service on and after 07/01/2017 through 12/31/2017. See ForwardHealth Update 2018-01 for more information regarding this reimbursement increase. www.forwardhealth.wi.gov/kw/pdf/2018-01.pdf Behavioral, Occupational, and Physical Therapy Procedure Code Changes Additions, deletions, and revisions to Behavioral, Occupational, and Physical Therapy codes went into effect 01/01/2018. See ForwardHealth Update 2018-04 for information regarding these code changes. www.forwardhealth.wi.gov/kw/pdf/2018-04.pdf Durable Medical Equipment (DME) Discontinued DME Adaptive Equipment Code and Other Code Additions/Revisions Procedure code A9900 has been discontinued effective 12/01/2017. For dates of service on and after 01/01/2018, adaptive equipment authorized under A9900 with modifiers (listed below) are to be authorized using E1399, Durable Medical Equipment, Miscellaneous (must specify complete description of DME on claims). Inclusa has terminated A9900 authorizations, and created new authorizations using E1399. Please review any affected authorizations for accurate billing to WPS. Codes affected:  A9900 U1 – Adaptive eating utensil, weighted handle  A9900 U2 – Adaptive eating utensil, non-weighted handle  A9900 U3 – Rocker knife  A9900 U4 – Plate guard  A9900 U5 – Scoop dish  A9900 U6 – Universal cuff  A9900 U7 – Dycem  A9900 U9 – Sock/stocking aid  A9900 UA – Dressing stick  A9900 UB – Long-handled shoe horn  A9900 UD – Adaptive hygiene aids See ForwardHealth Update 2018-04 for this and other code additions and revisions. www.forwardhealth.wi.gov/kw/pdf/2018-04.pdf