CASE Case & TODD Other Service Providers Case 7 (IN-ST) 81 171M00000X Manager/Care Coordinator LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc Other Service Providers Case Manager/Care Coordinator OAAS CASE Case MGMT 8 81 171M00000X HOSPICE Hospice SERVICES Service for Nursing & Custodial Care 9 (IN-ST) 93 Dual Elig. 315D00000X Facilities Hospice, Inpatient COMM Clinic or SUPPORT Other Group Agencies In Home Supportive 10 SRV 70 Practice 253Z00000X Care SHARED LIVING (WVR) Disabled Nursing Service Related 11 4A (DD) 372600000X Providers Adult Companion Ambulatory Health Care Facilities Clinic/Center Physical 12 THER (IN-ST) 5M Therapy 261QP2000X Therapy PREVOC REHAB Agencies Day Training, (WVR) Developmentally Disabled 13 36 Habilitation 251C00000X Services DAY HABILITAT Ambulatory Health Care (WVR) Day Facilities Clinic/Center Adult 14 50 Habilitation 261QA0600X Day Care ENVIR ACC ADAP (WVR) Other Service Providers 15 (IN-ST) 80 Adaptations 171W00000X Contractor Personal Emergency PERS EMERG Response RESP SYS Sys Suppliers Emergency Response 16 (WVR) 90 (Waiver) 333300000X System Companies Respiratory, Developmental, Rehabilitative and Restorative ASSISTIVE Service Providers Rehabilitation DEVICES Assistive Counselor Assistive Technology 17 (WVR) 91 Devices 225CA2400X Practitioner COMM MENTAL Community HLTH Mental Ambulatory Health Care CTR/PART Health Facilities/Clinic/Center, Mental 18 HOSP 5H Center 261QM0801X Health
7 CASE & TODD (IN-ST) 81 Case 171M00000X Other Service Providers Case Manager/Care Coordinator LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc 8 OAAS CASE MGMT 81 Case 171M00000X Other Service Providers Case Manager/Care Coordinator 9 HOSPICE SERVICES (IN-ST) 93 Hospice Service for Dual Elig. 315D00000X Nursing & Custodial Care Facilities Hospice, Inpatient 10 COMM SUPPORT SRV 70 Clinic or Other Group Practice 253Z00000X Agencies In Home Supportive Care 11 SHARED LIVING (WVR) 4A Disabled (DD) 372600000X Nursing Service Related Providers Adult Companion 12 THER (IN-ST) 5M Therapy 261QP2000X Ambulatory Health Care Facilities Clinic/Center Physical Therapy 13 PREVOC REHAB (WVR) 36 Habilitation 251C00000X Agencies Day Training, Developmentally Disabled Services 14 DAY HABILITAT (WVR) 50 Day Habilitation 261QA0600X Ambulatory Health Care Facilities Clinic/Center Adult Day Care 15 ENVIR ACC ADAP (WVR) (IN-ST) 80 Adaptations 171W00000X Other Service Providers Contractor 16 PERS EMERG RESP SYS (WVR) 90 Personal Emergency Response Sys (Waiver) 333300000X Suppliers Emergency Response System Companies 17 ASSISTIVE DEVICES (WVR) 91 Assistive Devices 225CA2400X Respiratory, Developmental, Rehabilitative and Restorative Service Providers Rehabilitation Counselor Assistive Technology Practitioner 18 COMM MENTAL HLTH CTR/PART HOSP 5H Community Mental Health Center 261QM0801X Ambulatory Health Care Facilities/Clinic/Center, Mental Health
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx