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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