Attachment A
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- Tobias Atkins
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1 Attachment A Description Definition Speech and Language Therapy Treatment of Speech, language, voice, communication and/or auditory processing disorder (Includes aural Cognitive Therapy Development of cognitive skills to improve attention, memory, problem solving, (includes compensatory training), direct (one-on-one) patient contact by the provider Respite care services, (Consumer) S5150 Unskilled respite care, not hospice; utes Respite (CSLA)- TT Respite care services, up to utes Respite care services, (Agency ) - Respite care services, up to utes W0700 R.N.,Private Duty Nursing - el Program T1000 TD Private duty / independent nursing service(s) - licensed, up to utes W0701 L.P.N.,Private Duty Nursing - el Program T1000 TE Private duty / independent nursing service(s) - licensed, up to utes W0703 Case Management - el T1017 Targeted case management, each utes W0705 W1700 Aging DME and supplies - el Personal Care Services provided in a consumer's home by a qualified person who is under the supervision of a Registered Nurse. Unit of Service - A9900 W1700 Miscellaneous DME supply, accessory, and/or service component of another HCPCS code Personal Care Services provided in a consumer's home by a qualified person who is under the supervision of a Registered Nurse. Unit of Service - 15 per misc supply W1701 W1702 Aging Aging A generic code for personal care services provided in a consumer's home by a qualified person who is under the supervision of a Registered Nurse. This code is for units of service that are greater than hourly, such as, a 24 hr shift, weekly shift or other. Respite services provided in a consumer s home to relieve family members or primary caregivers who normally provide care. Services are provided for less than 24 hrs. Unit of service -. W1701 W1702 A generic code for personal care services provided in a consumer's home by a qualified person who is under the supervision of a Registered Nurse. This code is for units of service that are greater than hourly, such as, a 24 hr shift, weekly shift or other. Respite services provided in a consumer s home to relieve family members or primary caregivers who normally provide care. Services are provided for less than 24 hrs. Unit of service -. one shift W1703 W1704 Aging Aging A generic code for respite services provided in a consumer's home to relieve family members or primary caregivers who normally provide care. This code is for units of service that are greater than hourly, such as, a 24 hr shift, weekly shift or other. Respite services provided in an approved long term care facility to relieve family members or primary caregivers who normally provide care. Unit of Service 24 hours. W1703 A generic code for respite services provided in a consumer's home to relieve family members or primary caregivers who normally provide care. This code is for units of service that are greater than hourly, such as, a 24 hr shift, weekly shift or other. per diem S5151 Unskilled respite care, not hospice; per diem per diem W1713 Aging Medical and surgical supplies that are not listed on the state Plan. Unit of service = one item A4649 Surgical supply, miscellaneous one item W1713 Aging Medical and surgical supplies that are not listed on the state Plan. Unit of service = one item T2028 Specialized supply, NOS, waiver one item W1714 Aging Durable Medical Equipment that is not listed on the State Plan. Unit of service - one item. E1399 Durable Medical Equipment, miscellaneous one item A - 1
2 Description Definition W1717 Aging Generic Medical Equipment and Supplies that are not listed on the State Plan and do no fit into the categories of medical and surgical supplies, durable medical equipment orthotic devices or prosthetic devices. T2028 Specialized supply, NOS, waiver one item W1736 Aging Services of a home health aide - Must be supervised by a RN. Unit of service - 1/4 hour G0156 TU, or TV, or Services of home health aide in home health setting, each utes W1737 Aging L.P.N. Unit of service - T1003 TU or LPN/LVN services, up to utes W1738 Aging R.N. Basic Evaluation. Unit of Service - Visit T1001 TU or Nursing assessment / evaluation W1739 Aging R.N. Specialist Evaluation Unit of Service - Visit T1001 TU or Nursing assessment / evaluation W1740 W1743 W1750 Aging Aging Aging Aging Physical Therapy, Unit of Service - Visit S9131 Physical therapy; in the home, per diem per diem Generic code for other home health costs. Unit of Service - Visit Generic code for all other counseling activities or therapies that aren't listed. This code includes counseling over the telephone. Unit of service - per contact TU, or TV, or Unlisted home visit service or procedure H0046 Mental health services, not otherwise specified per contact Care - Combination Option S5125 care services; utes Care Care - Combination Option Care (Consumer) - Care Personal Care Services (Consumer) - S5125 Care Services; S5125 Care Services; Aging Care Care - Agency Option S5125 care services; utes Care (Agency) - Care Personal care services, utes, not for an Personal Care Services (Agency) - Personal Care Services (CSLA) - Personal care services, utes, not for an TT Personal care services, utes, not for an A - 2
3 W1794 W1794 Aging Care Description Definition Attachment A care - coordination S5126 care services; per diem per diem care - coordination W1794 Care Service Coordination Per month W1801 Occupational Therapy G0152 Services of occupational therapist in home health setting, each utes W1802 W1877 W1877 W1881 Physical Therapy Therapeutic procedure, one or more areas, each 15 utes; therapeutic exercises to develop strength and Supports Coordination - W1877 Service Coordination per hr Supports Coordination - W1877 Service Coordination per hr Medical Equipment and Supplies (Over $100) W1896 OBRA Assistive Technology ($100 or less) OBRA Purchase W1898 Medical Equipment and Supplies ($100 or less) Miscellaneous Durable Medical Equipment - OBRA W6002 OBRA Behavioral Therapy Coach - OBRA Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact by the provider. W6002 W6002 Behavioral Therapy (Coach, Agency) - Behavioral Therapy (Coach, Consumer) Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact by the provider. H2019 Therapeutic behavioral services, W6004 OBRA Behavioral Therapy (Assessment) -OBRA H0002 Behavioral health screening to detere eligibility for admission to treatment program per session W6042 Night Supervision /Weekdays (Consumer, Weekdays) Services requested between 10pm and 8am in addition to basic service W6042 W6043 W6043 Night Supervision/Weekdays (Agency, Weekdays) - - Night Supervision/Weekend (Agency, Weekends) - Night Supervision/Weekend (Consumer, Weekends) - Personal Care services; utes; not inpatient or Services provided at night. TV Personal Care services; utes; not inpatient or Special Payment rate, holidays/weekends Service requested on Sundays and holidays in addition to basic service. W6100 OBRA Resource Management Supports Coordination - OBRA 1 week W6100 Resource Management Supports Coordination - OBRA 1 week per week Daily Living and Home Support (Consumer) - S5125 care services; utes OBRA Daily Living and Home Support (Consumer) OBRA - S5125 care services; utes A - 3
4 Description Definition Daily Living and Home Support - (Agency) - Daily Living and Home Support - (CSLA) - OBRA Daily Living and Home Support- (Agency) OBRA - OBRA Daily Living and Home Support - (CSLA) OBRA - Personal Care services; utes, not inpatient or TT Personal Care services; utes, not inpatient or Personal Care services; utes, not inpatient or TT Personal Care services; utes, not inpatient or Respite (Consumer) - - S5150 Unskilled respite care, not hospice; utes OBRA Respite (Consumer) - OBRA - S5150 Unskilled respite care, not hospice; utes Respite (Agency) - - Respite care services, up to utes Respite (CSLA) - - TT Respite care services, up to utes OBRA Respite (Agency) - OBRA - Respite care services, up to utes OBRA Respite (CSLA) - OBRA - TT Respite care services, up to utes Speech Therapy Treatment of speech, language, voice, communication, and/or auditory processing disorder (includes aural OBRA Speech Therapy - OBRA Treatment of speech, language, voice, communication, and/or auditory processing disorder (includes aural Physical Therapy Therapeutic procedure, one or more areas, each 15 utes; therapeutic exercises to develop strength and OBRA Physical Therapy - OBRA Therapeutic procedure, one or more areas, each 15 utes; therapeutic exercises to develop strength and Occupational Therapy - - G0152 Services of occupational therapist in home health setting, each utes OBRA Occupational Therapy - OBRA - G0152 Services of occupational therapist in home health setting, each utes Behavioral Therapy - - H0004 Behavioral health counseling and therapy OBRA Behavioral Therapy - OBRA - H0004 Behavioral health counseling and therapy A - 4
5 Description Definition W6112 Visiting Nurse (LPN) G0154 TE Services of skilled nurse in-home health setting, each W6112 Visiting Nurse (RN) - - G0154 TD Services of skilled nurse in-home health setting, each W6112 OBRA Visiting Nurse (LPN) - OBRA - G0154 TE Services of skilled nurse in-home health setting, each W6112 OBRA Visiting Nurse (RN) - OBRA - G0154 TD Services of skilled nurse in-home health setting, each W6113 OBRA Assistive Technology (over $100) - OBRA W7003 Behavioral Health Counseling and Therapy - - H0004 Behavioral health counseling and therapy, per 15 utes W7007 Assistive Technology/Specialized Medical Equipment/Supplies Under $100 Assistive Technology - W7010 Part Time Nursing (RN) G0154 TD Services of skilled nurse in-home health setting, each W7010 Part Time Nursing (LPN) G0154 TE Services of skilled nurse in-home health setting, each W7011 Assistive Technology/Specialized Medical Equipment/Supplies Over $100 (Requires Prior Auth) Miscellaneous Durable Medical Equipment - Assistive Technology - W7021 W7022 Shared care (one RN to care for multiple clients simultaneously). Unit of service - 1 hour. Shared care (one LPN to care for multiple clients simultaneously). Unit of service - 1 hour. T1002 TT RN services, up to utes T1003 TT LPN/LVN services, up to utes W7025 W7026 Individual Respite Care - R.N. TD Respite care services, up to utes Individual Respite care - L.P.N. TE Respite care services, up to utes W7027 Shared Respite Care - R.N. TD & TT Respite care services, up to utes W7028 Shared Respite care - L.P.N. TE & TT Respite care services, up to utes W7036 Care - Agency Option Blended Rate S5125 care services; utes W7037 Care - Combination Option - Blended Rate S care services; utes W7040 R.N. Consultation fee for supervision and certification of attendant care under Michael Dallas T1002 RN services, up to utes Y9609 Behavioral Specialist Consultant (Master's Level - MA Fee includes travel and Adistration) - H0032 U7 Mental health service plan development by a nonphysician A - 5
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