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1 Mi Via Procedure s and Rates Effective Description Unit Does Change? Description Unit Rate Homemaker/Companion Hour No, name change Homemaker/Direct Same rate $ Support G0151 Physical therapy 15 min No Same rate $ G0152 Occupational therapy 15 min No Same rate $ G0153 Speech/Language 15 min No Same rate $ pathology G9002 Intensive Case Management Hour Yes, no longer available T1005RS Respite Standard 15 min Yes T1005HM Same rate $3.38 T1005 RN Respite RN 15 min No Same rate $10.90 T1005 LPN Respite LPN 15 min No Same rate $6.79 T1005 HHA Respite Home Health Aide 15 min No Same rate $4.08 H2021 Community Access 15 min No, name change Community Direct $1.88-$15.48 Support/Navigation H2019 Behavior Support 15 min No Same rate $12.24-$20.65 Consultation S5160 Emergency Responsetesting Each No Same rate-negotiated and maintenance S5161 Emergency Response- Month No Same rate $36.71-$40.79 Monthly service fee S5165 Environmental Mods Each No Same rate-each S9470 Nutritional Counseling- Hour No Same rate $42.83 Adults T1002 Private Duty Nursing- 15 min No Same rate $10.90 Adults-RN T1003 Private Duty Nursing- Adults-LPN 15 min No Same rate $6.79 1
2 Mi Via Procedure s and Rates Effective Description Unit Does Change? T2019 Supported employment 15 min No, name change Description Unit Rate Employment Supports (includes Job Coach) NEW T2019U1 Job Developer Each $100-$700 Same rate $2.15-$6.93 T2018 Supported employment Day Yes-no longer available T2021 Adult Day Habilitation 15 min Yes S5100 Customized 15 min $1.36-$8.82 Community Support S5100 Adult Day Health 15 min Yes, name change S5100 Customized 15 min $1.36-$8.82 Community Support T2033FL Family Living Day Yes, name change T2033 Customized In Home Day $25.00-$ Living Supports T1005SC Substitute Care 15 min Yes, no longer available, CMS has instructed that this service needs to be built into the daily rate. T2033SL Supported Living Day Yes, name change T2033 Customized In Home Day $25.00-$ Living Supports T2031 Assisted Living Day No T2030 Independent Living Month Yes T2033 Customized in Home Living supports Day $25.00-$
3 Mi Via Procedure s and Rates Effective Description Unit Does Change? Description Unit Rate T1999TD-H Transportation/Driver Hour Yes T2007 Transportation Time hour Minimum wage-$14.60 T1999TD-I Transportation/Driver Each/Trip Yes T2003 Transportation Trip Each Same rate- Negotiated T1999MILE Transportation Per Mile Yes T2049 Transportation Mile Mile $.34-.$40 NEW T2004 Transportation Commercial Carrier Pass T1999CP-H Community Participation Hour Yes H2021 Community Direct Support/Navigation T1999CP-I Community Item Yes T1999U4 Fees and T1999HG-H Participation/item invoice Household related goods and services/hourly service (ie, lawn mowing) Unit Each 15 min $2.00-$15.48 Each Same rate-negotiated memberships Hour No T1999U2 Same rate-negotiated T1999CE-H Coaching/education for Hour Yes, no longer parents, spouse or others T1999CE-I Coaching/education for Each No T1999U6 Same rate-negotiated parents, spouse or others T1999RF-H Resource Facilitation Hour Yes, no longer T1999RF-I Resource Facilitation Each Yes, no longer T1999TS Technology for safety and independence Each No T1999U3 Same rate-negotiated 3
4 Mi Via Procedure s and Rates Effective T1999AMT T1999HR-I Description Unit Does Change? Alternative Medicine and Therapies Health related Service, Equipment and Supplies Description Unit Rate Each Yes, no longer (see breakout of specialized therapies) Each No T1999U5 Same rate-negotiated NEW S9122 Home Health Aide Hour Minimum wage-$16.32 NEW T1007 Personal Plan Each $100-$650 Facilitation NEW Acupuncture 15 min $12.50-$25.00 NEW Biofeedback Visit $50.00-$ NEW Chiropractic Visit $50.00-$ NEW Cognitive Rehab 15 min $12.50-$25.00 Therapy NEW S8940 Hippotherapy Visit $50.00-$ NEW Massage Therapy 15 min $12.50-$
5 Mi Via Procedure s and Rates Effective Description Unit Does Change? Description Unit Rate NEW S8990 Naprapathy Visit $50.00-$ NEW S9445 Native American session Negotiated Healers NEW H2032 Play therapy 15 min $12.50-$
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