TO:                 All Personal Care Service (PCS) Providers and School Districts Providing Medicaid Services

 

FROM:           Leslie M. Clement, Deputy Administrator

 

 

Effective July 1, 2005, Medicaid will make some changes to its reimbursement rates for Personal Assistance Services (personal care and attendant services).  As required by Idaho Code and IDAPA 16.03.09.148, the Department conducted a salary survey to calculate the new rates.  The maximum allowable amounts are based on wages and salaries paid for comparable positions within nursing facilities and intermediate care facilities for the mentally retarded (ICF/MRs).

 

G9002 Coordinated Care Fee – Maintenance Rate (Agency)                    $ 69.93/visit

G9001 Coordinated Care Fee – Initial (School)                                        $ 69.93/plan    

T1001  Nursing Assessment/Evaluation (Agency)                                      $ 34.08/visit

T1001  Nursing Assessment/Evaluation (School)                                       $ 34.08/visit

 

G9001 Coordinated Care Fee – Initial (Agency)                                       $ 89.53/visit

H2020 Therapeutic Behavioral Services (Agency)                                     $ 29.84/day

 

T1019              Personal Care                                                                  $ 3.49/15 min. unit

T1004              Services of a Qualified Nursing Aide                                 $ 3.49/15 min. unit

S5145              Foster Care, Therapeutic – Child                                      $ 72.67/day

S5145 HQ[1]      Foster Care, Therapeutic – Group                                 $ 62.43/day per client

 

Independent Provider’s Home (no withholding)

S5145              Foster Care, Therapeutic – Child                                     $ 69.46/day

          (Children under Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program only)

S5145 HQ1      Foster Care, Therapeutic – Group                                  $ 51.02/day per client

          (Children under EPSDT Program only)     

                                           

S5125 U21       Attendant Care Services                                                $ 3.49/15 min. unit

T1001 U21       Nursing Assessment/Evaluation (Agency)                       $ 34.08

 

 S5140-U2        Adult Residential Care                                      **

            **  For Certified Family Homes and Residential and Assisted Living Facilities that bill this          code, you will receive a letter notifying you of the new rate for each participant.  If you do not receive a letter for a participant living in your facility, please notify your local Regional Medicaid  Services unit. Approval of service by the Regional Medicaid Services unit is still required prior to delivery of service.

If you have questions about this process, please contact your Regional Medicaid Services office.   Thank you for your participation in the Idaho Medicaid Program.

 

This information release does not replace information in your Idaho Medicaid Provider Handbook.

 

LC/sp

 

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