HCBS 2019 Reimbursement - kmap-state-ks.us

1 DXC Technology is the fiscal agent of kmap . Page 1 of 4 kmap HCBS BULLETIN 18114 MAY 2018 kmap Kansas Medical Assistance Program Bulletins Manuals Forms Customer Service 1-800-933-6593 7:30 - 5:30 Monday - Friday HCBS 2019 Reimbursement Effective with dates of service on and after July 1, 2018, the fees for certain Home and Community Based services (HCBS) Autism, Frail Elderly, Intellectual/Developmentally Disabled (I/DD), Physical Disability, Severe Emotional Disturbance, Technology Assisted, and Traumatic Brain Injury codes will increase by 4%. The procedure codes and rates are on the following pages entitled HCBS services . The following tiered HCBS I/DD service codes for provider type/provider specialty (PT/PS) 55/364 will also increase: T2016 and T2021.

2 The updated rates are on the final page entitled HCBS I /DD Reimbursement and at the HCBS I/DD Reimbursement link on the Provider page of the Kansas Medical Assistance ( kmap ) website. Note: The effective date of the policy is July 1, 2018. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program ( kmap ) bulletins. The KanCare Open Claims Resolution Log on the kmap Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented. Note: Refer to the CPT codebook for complete descriptions. CPT codes, descriptors, and other data only are copyright 2018 American Medical Association (or such other date of publication of CPT). All rights reserved. Applicable FARS/DFARS apply. Information is available on the American Medical Association website.

3 1 of 2 Updated CodeOld RateFY2018 RateFY2019 RateBehavior TherapyH0004$ $ $ RehabilitationG0515$ $ $ Management ServicesT2040 U2$ $ $ MealsS5170$ $ $ ReminderS5185$ $ $ Reminder/DispenserT1505 UB$ $ $ Reminder/Dispenser InstallationT1505$ $ $ TherapyG0152$ $ $ Emergency Response System InstallationS5160$ $ $ Emergency Response System RentalS5161$ $ $ services /Agency-DirectedS5125 U9$ $ $ services /Self-DirectedS5125 UB$ $ $ TherapyG0151$ $ $ Cycle Support/Enhanced care ServiceT2025$ $ $ TherapyG0153$ $ $ Living SkillsH2014$ $ $ CodeOld RateFY2018 RateFY2019 RatePersonal services Self-DirectedS5125 U6$ $ $ Management ServicesT2040 U2$ $ $ MealsS5170$ $ $ ReminderS5185$ $ $ Reminder DispenserT1505 U6$ $ $ Reminder/Dispenser InstallationT1505$ $ $ Emergency Response System InstallationS5160$ $ $ Emergency Response System RentalS5161$ $ $ services /Agency-DirectedS5125 U9$ $ $ Cycle Support/Enhanced care ServiceT2025$ $ $ CodeOld RateFY2018 RateFY2019 RateRespiteT1005$ $ $ Support (individual rate)T1027$ $ $ Support (group rate)T1027 HQ$ $ $ Adjusted Counseling (Individual rate)S9482$ $ $ Adjusted Counseling (group rate)S9482 HQ$ $ $ CodeOld RateFY2018 RateFY2019 RateAdult Day care (1-5 hours)S5101$ $ $ Day care (5 plus hours)S5102$ $ $ care services Level 1S5130$ $ $ care services Level 2S5125$ $ $ care services Level 3S5125 UA$ $ $ care services (self-direct)S5125 UD$ $ $ Support (provider directed)S5135$ $ $ Support (self-directed)

4 S5135 UD$ $ $ Management ServicesT2040 U2$ $ $ telehealth (install)S0315$ $ $ telehealth (rental)S0317$ $ $ reminderS5185$ $ $ Evaluation visitT1001$ $ $ Emergency Response System InstallationS5160$ $ $ Emergency Response System RentalS5161$ $ $ Cycle Support/Enhanced care ServiceT2025$ $ $ MonitoringS5190$ $ $ CodeOld RateFY2018 RateFY2019 RateHealth Maintenance MonitoringT1001$ $ $ Intensive Medical CareT1002$ $ $ Medical CareT1000$ $ $ care services - Agency DirectedT1004$ $ $ care services - Self DirectedT1019$ $ $ Respite CareT1005$ $ $ Management ServicesT2040 U2$ $ $ Elderly (FE)Technology Assisted (TA)HCBS ServicesTRAUMATIC BRAIN INJURY (TBI)Physical Disability (PD)Autism (AU)2 of 2 Updated CodeOld RateFY2018 RateFY2019 RateOvernight RespiteH0045$ $ $ care ServicesT1019$ $ $ Cycle Support/Enhanced care ServiceT2025$ $ $ Medical care (RN)T1000 TD$ $ $ Medical care (LPN)T1000$ $ $ Home CareS5125$ $ $ EmploymentH2023$ $ $ Alert RentalS5161$ $ $ Management ServicesT2040 U2$ $ $ MonitoringS5190$ $ $ Supports (adult)T2016 See tiered ratesSee tiered ratesSee tiered ratesResident Supports (Child)T2016 See tiered ratesSee tiered ratesSee tiered ratesDay Supports - Day SupportsT2021 See tiered ratesSee tiered ratesSee tiered ratesDay Supports - Pre-Vocational SupportsT2021 See tiered ratesSee tiered ratesSee tiered ratesServicesProcedure CodeOld RateFY2018 RateFY2019 RateAttendant care SED WaiverT1019-HK$ $ $ Living / Skills BuildingT2038$ $ $ Support and Training IndividualS5110$ $ $ Support and Training - GroupS5110-TJ$ $ $ Resource Family CareS9485$ $ $ Term Respite CareS5150$ $ $ FacilitationH2021$ $ $ Disabilities (I/DD)

5 SED WaiverHCBS ServicesUpdated CodeProvider TypeSpecialtyOld RateFY2018 RateFY2019 RateUnit DefinitionRegular Tier 1T201655364$ $ $ unit = 1 dayRegular Tier 2T201655364$ $ $ unit = 1 dayRegular Tier 3T201655364$ $ $ unit = 1 dayRegular Tier 4T201655364$ $ $ unit = 1 dayRegular Tier 5T201655364$ $ $ unit = 1 daySuper Tier 1T201655364$ $ $ unit = 1 daySuper Tier 2T201655364$ $ $ unit = 1 daySuper Tier 3T201655364$ $ $ unit = 1 daySuper Tier 4T201655364$ $ $ unit = 1 daySuper Tier 5T201655364$ $ $ unit = 1 dayRegular Tier 1T202155520$ $ $ unit = 15 minutesRegular Tier 2T202155520$ $ $ unit = 15 minutesRegular Tier 3T202155520$ $ $ unit = 15 minutesRegular Tier 4T202155520$ $ $ unit = 15 minutesRegular Tier 5T202155520$ $ $ unit = 15 minutesSuper Tier 1T202155520$ $ $ unit = 15 minutesSuper Tier 2T202155520$ $ $ unit = 15 minutesSuper Tier 3T202155520$ $ $ unit = 15 minutesSuper Tier 4T202155520$ $ $ unit = 15 minutesSuper Tier 5T202155520$ $ $ unit = 15 minutesHCBS I/DD Reimbursement Tiered RatesResidential SuportsResidential SupportsDay SupportsDay Supports