Assistive Care Services and Assisted Living for the Elderly Waiver
Assistive Care Services and Assisted Living for the Elderly Waiver
Assistive Care Services and Assisted Living for the Elderly Waiver
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<strong>Assistive</strong> <strong>Care</strong> <strong>Services</strong> <strong>and</strong> <strong>Assisted</strong> <strong>Living</strong> <strong>for</strong> <strong>the</strong> <strong>Elderly</strong> <strong>Waiver</strong> <strong>Services</strong><br />
Coverage <strong>and</strong> Limitations H<strong>and</strong>book<br />
PART I<br />
CHAPTER 3<br />
ASSISTIVE CARE SERVICES<br />
PROCEDURE CODES AND FEES<br />
Overview<br />
Introduction<br />
This chapter provides <strong>and</strong> describes <strong>the</strong> procedure codes <strong>and</strong> approved fees<br />
<strong>for</strong> <strong>the</strong> <strong>Assistive</strong> <strong>Care</strong> <strong>Services</strong> (ACS) program.<br />
In this Chapter<br />
This chapter contains:<br />
TOPIC<br />
PAGE<br />
Reimbursement In<strong>for</strong>mation 3-1<br />
Appendix A: Procedure Code Table <strong>and</strong> Fees A-1<br />
Appendix B: Appeal Rights <strong>and</strong> Fair Hearing Process B-1<br />
Appendix C: Optional Certification of Medical Necessity<br />
Form<br />
Appendix D: Optional ACS Service Plan From <strong>and</strong><br />
Instructions<br />
Appendix E: Optional Resident Service Log <strong>and</strong><br />
Instructions<br />
C-1<br />
D-1<br />
E-1<br />
Reimbursement In<strong>for</strong>mation<br />
Introduction<br />
Medicaid reimburses <strong>for</strong> assistive care services procedure code based on <strong>the</strong><br />
Healthcare Common Procedure Coding System (HCPCS), Level III<br />
procedure codes <strong>and</strong> locally assigned codes that have been approved by<br />
CMS, <strong>for</strong>merly known as HCFA. Locally assigned codes are identified by a<br />
“W” prefix.<br />
July 2001 3-1