View Article

Current Articles | Archives | Search

Back

MEDICAID INFORMATION RELEASE MA06-21

posted on March 02, 2009 12:18

July 6, 2006

MEDICAID INFORMATION RELEASE MA06-21

TO: DDA, Residential Habilitation Providers

FROM: Leslie M. Clement, Administrator

SUBJECT: RATE INCREASE DEVELOPMENTAL DISABILITY SERVICES AND RESIDENTIAL HABILITATION SERVICES EFFECTIVE JULY 1, 2006

This Information Release replaces the letter sent out to the Medicaid Developmental Disability Services Providers dated June 20, 2006.

Beginning July 1, 2006, the Department of Health and Welfare is authorized to increase the rates paid to providers of developmental disability services for certain services not to exceed 1.9% for fiscal year 2007. These services include developmental therapy evaluation, developmental therapy for groups and individuals, supported living for groups and individuals, comprehensive community support/daily, and community-based services/daily.

Effective July 1, 2006, the new rates for these services will be as follows:

Procedure Code	Modifier	Procedure Description Short	Current Rate	New Rate
H2000		DEVELOPMENTAL THERAPY EVALUATION -C	$4.45	$4.53
H2014*	HQ	DEVELOPMENTAL THERAPY/GROUP	$1.77	$1.80
H2014*		DEVELOPMENTAL THERAPY/INDIVIDUAL	$4.45	$4.53
H2014*	HQ/U4	DEV THERAPY/GROUP FOR N.F.R	$2.10	$2.14
H2014*	U4	DEV THERAPY/IND FOR N.F. REC	$4.92	$5.01
H2015	U8	SUPPORTED LIVING - 1 CONSUMER-ADULTS	$3.18	$3.24
H2015	HQ/U8	SUPPORTED LIVING-2 CONSUMERS-ADULTS	$1.87	$1.91
H2016 **		SCHOOL DAYS HIGH SUPPORT	$175.00	$178.33
H2016 **		SCHOOL DAYS INTENSE SUPPORT	$208.50	$212.46
H2016 **		NON SCHOOL DAYS INTENSE SUPPORT	$263.66	$268.66
H2016	U8	SUPPORTED LIVING INTENSE FOR ADULTS	$263.66	$268.66
H2021 *	HQ	DEVELOPMENTAL THERAPY GROUP	$2.10	$2.14
H2021 *		DEVELOPMENTAL THERAPY INDIVIDUAL	$4.92	$5.01
H2022	U8	SUPPORTED LIVING HIGH FOR ADULTS	$221.12	$225.32
H2022*		NON-SCHOOL DAYS HIGH SUPPORT	$221.12	$225.32
H2032		DEVELOPMENTAL THERAPYINDIVIDUAL-ADULTS	$4.45	$4.53
H2032	HQ	DEVELOPMENTAL THERAPYGROUP-ADULTS	$1.77	$1.80
H2032	U4	DEV THERAPY/INDIVIDUAL FOR N.F.REC	$4.92	$5.01
97537		DEV THERAPY/INDIVIDUAL- HOME OR COMM-ADULTS	$4.92	$5.01
97537	HQ	DEV.THERAPY/GROUPS of 2 IN HOME OR COMM-ADULTS	$2.10	$2.14
* Procedure code for services to children ** New rates effective July 2, 2006

Providers will be able to bill the new prices starting July 2006 without submitting an addendum to the participants plan.

If you have any questions please contact Gynna Loper, Senior Financial Specialist in the Division of Medicaid Office of Reimbursement Policy, at (208) 364-1994.

Thank you for your continued participation in the Idaho Medicaid program.

LMC/gl/sw

E-mail this article