This section establishes Medicaid reimbursement rates and procedure codes for Community Support Services, including Comprehensive Community Support, Assertive Community Treatment, Psychosocial Rehabilitation, Skills Development, Peer Support, and Behavioral Health Day Treatment. Operators must bill using the specified HIPAA/procedure codes and apply the applicable rate schedule based on the date of service. Providers receiving rate increases effective August 1, 2018 must ensure the increase is passed through to direct-service employee wages and benefits, and must document and retain evidence of compliance for Department review.
View official sourcePROC CODE DESCRIPTION UNIT MAXIMUM ALLOWANCE MAXIMUM ALLOWANCE MAXIMUM ALLOWANCE HIPAA CODES Section 17 Services RATE through 7/31/2018* RATE from 8/1/18 to 6/30/19** RATE from 7/1/19** H2015 Comprehensive Community Support Services (Community Integration Services) 15 minutes $20.86 $21.32 $21.28 H0040 Assertive Community Treatment (Assertive Community Treatment) Per Diem By Report By Report By Report H0038 CIPSS-Self Help/peer services 15 minutes $11.10 $11.34 $11.32 H2017 Psychosocial Rehabilitation (Daily Living Support Services) 15 minutes $7.77 $7.94 $7.93 H2018 Psychosocial Rehabilitation Service (Community Rehabilitation Services ) Per Diem $74.39 $76.01 $75.88 H2014 Skills Training and Development (Skills Development Services) 15 minutes $12.20 $12.46 $12.44 H2014 HQ Skills Training and Development (Skills Development Services) 15 minutes $3.05 $3.32 $3.11 H2025 Ongoing Support to Maintain Employment (Skills Development Services/training) 15 minutes $12.20 $12.46 $12.44 H2012 Behavioral Health Day Treatment (Day Support Services) Per hour By Report By Report By Report *The Department is seeking and anticipates receiving CMS approval for this Section. Pending approval, the Department will reimburse providers under the new increased rate retroactively to 7/1/2016 through 7/31/2018 pursuant to P.L. 2015, ch. 477 (eff. Apr. 15, 2016). **The Department is seeking and anticipates receiving CMS approval for this Section. Pending approval, the Department will reimburse providers under the new increased rate retroactively to 8/1/2018 pursuant to P.L. 2017, ch. 460, Part D. Providers must ensure that the increase in reimbursement rates effective August 1, 2018 is applied in full to wages and benefits for employees who provide direct services. Providers must document compliance with this requirement in their financial records and provide such documentation to the Department upon request.