available for individuals receiving day habilitation services who temporarily lose their MassHealth and continue to need the services available through this service type. Hourly services are billed through the EIM system. Service units will be reported in quarter hour increments. One hour will equal four units. Contract Type Unit Rate Rate Type Chapter 257: Service Summary Form Attendance Unit Type (Used on ID#) HOURS Reimbursement Unit of Service 15 mins Cost/ Service Limit 6 hours per day (no exceptions) Waiver Eligible? No Meditech Enrollment? Yes H. ACTIVITY CODE 3681 (DDS/GROUP SUPPORTED EMPLOYMENT PARTNERSHIP) Group Supported Employment Services is a Public and Private partnership with both Agency and Provider staff for DDS individuals who reside in the Community. These employment services are to groups of DDS Clients working in a competitive environment in the community under the supervision of state staff and a provider agency. Emphasis is on work in integrated environment, with the opportunity for individuals to have contact with co-workers, customers, supervisors, and others without disabilities. DDS/Group Support Employment Partnerships may include small groups in industry (enclave); provider businesses/small business model; mobile work crews which allow for integration, and temporary services which may assist in securing an individual a position within a business. Contract Type Cost Reimbursement Rate Type Cost Reimbursement Attendance Unit Type (Used on ID#) Cost Reimbursement Reimbursement Unit of Service Cost Reimbursement Cost/ Service Limit NA Waiver Eligible? No Meditech Enrollment? Yes Object Code M04 ACTIVITY CODE 3764 (FACILITY DAY HABILITATION) I. Facility Day Habilitation is a program for individuals who reside at DDS facilities that cannot benefit from a DDS Community Based Day program due to functional and medical limitations. Day Habilitation is a program that provides the individuals with opportunity to develop their skills in the areas if sensory-motor, affective, behavioral, independent living, and social development. Hourly services are billed through the EIM system. Service units will be reported in quarter hour increments. One hour will equal four units. Contract Type Unit Rate Rate Type Mass Health Rate: Service Summary Form Attendance Unit Type (Used on ID#) HOURS Reimbursement Unit of Service 15 mins 6 hours per day. Prior approval required for additional Cost/ Service Limit hours Waiver Eligible? No
available for individuals receiving day habilitation services who temporarily lose their MassHealth and continue to need the services available through this service type. Hourly services are billed through the EIM system. Service units will be reported in quarter hour increments. One hour will equal four units. Contract Type Unit Rate Rate Type Chapter 257: Service Summary Form Attendance Unit Type (Used on ID#) HOURS Reimbursement Unit of Service 15 mins Cost/ Service Limit 6 hours per day (no exceptions) Waiver Eligible? No Meditech Enrollment? Yes H. ACTIVITY CODE 3681 (DDS/GROUP SUPPORTED EMPLOYMENT PARTNERSHIP) Group Supported Employment Services is a Public and Private partnership with both Agency and Provider staff for DDS individuals who reside in the Community. These employment services are to groups of DDS Clients working in a competitive environment in the community under the supervision of state staff and a provider agency. Emphasis is on work in integrated environment, with the opportunity for individuals to have contact with co-workers, customers, supervisors, and others without disabilities. DDS/Group Support Employment Partnerships may include small groups in industry (enclave); provider businesses/small business model; mobile work crews which allow for integration, and temporary services which may assist in securing an individual a position within a business. Contract Type Cost Reimbursement Rate Type Cost Reimbursement Attendance Unit Type (Used on ID#) Cost Reimbursement Reimbursement Unit of Service Cost Reimbursement Cost/ Service Limit NA Waiver Eligible? No Meditech Enrollment? Yes Object Code M04 I. ACTIVITY CODE 3764 (FACILITY DAY HABILITATION) Facility Day Habilitation is a program for individuals who reside at DDS facilities that cannot benefit from a DDS Community Based Day program due to functional and medical limitations. Day Habilitation is a program that provides the individuals with opportunity to develop their skills in the areas if sensory-motor, affective, behavioral, independent living, and social development. Hourly services are billed through the EIM system. Service units will be reported in quarter hour increments. One hour will equal four units. Contract Type Unit Rate Rate Type Mass Health Rate: Service Summary Form Attendance Unit Type (Used on ID#) HOURS Reimbursement Unit of Service 15 mins Cost/ Service Limit 6 hours per day. Prior approval required for additional hours Waiver Eligible? No