PROCEDURE MAXIMUM ALLOWANCE DESCRIPTION CODE Effective 7/1/18 EMPLOYMENT SPECIALIST SERVICES (Habilitation, supported T2019 $9.09 ¼ hr employment waiver) EMPLOYMENT SPECIALIST SERVICES (Habilitation, supported T2019 SC $10.51 ¼ hr employment waiver)- with Medical Add-On T2021 COMMUNITY SUPPORT (Day habilitation, waiver) $6.53 ¼ hour COMMUNITY SUPPORT (Day habilitation, waiver) with Medical Add SC $8.05 ¼ hr On 97755 ASSISTIVE TECHNOLOGY-ASSESSMENT $14.44 ¼ hr T2035 ASSISTIVE TECHNOLOGY (Utility Services) Up to $50.00 per month. –TRANSMISSION ASSISTIVE TECHNOLOGY (Monitoring feature/device, –DEVICES Per invoice up to $6,000.00 per stand alone or integrated, any type, includes all accessories, components year and electronics, not otherwise classified) SPECIALIZED MEDICAL EQUIPMENT AND SUPPLIES Per itemized invoice S5165 CG HOME ACCESSIBILITY ADAPTATIONS (Repairs) Per itemized invoice S5165 HOME ACCESSIBILITY ADAPTATIONS (Home Modifications) Per itemized invoice COMMUNICATION AIDS - SPEECH AMPLIFIER, AIDS, V5274 COMMUNICATORS (INCLUDING REPAIR AND MAINTENANCE), Per itemized invoice ASSISTIVE DEVICES COMMUNICATION AIDS - ONGOING VISUAL-GESTURAL AND GN $5.40 ¼ hr FACILITATED COMMUNICATIONS SERVICES G9007 NON-traditional communication CONSULTATION $9.00 ¼ hr NON-traditional communication assessment $9.00 ¼ hr
PROCEDURE CODE DESCRIPTION MAXIMUM ALLOWANCE Effective 7/1/18 T2019 EMPLOYMENT SPECIALIST SERVICES (Habilitation, supported employment waiver) $9.09 ¼ hr T2019 SC EMPLOYMENT SPECIALIST SERVICES (Habilitation, supported employment waiver)- with Medical Add-On $10.51 ¼ hr T2021 COMMUNITY SUPPORT (Day habilitation, waiver) $6.53 ¼ hour SC COMMUNITY SUPPORT (Day habilitation, waiver) with Medical Add On $8.05 ¼ hr 97755 ASSISTIVE TECHNOLOGY-ASSESSMENT $14.44 ¼ hr T2035 ASSISTIVE TECHNOLOGY –TRANSMISSION (Utility Services) Up to $50.00 per month. ASSISTIVE TECHNOLOGY –DEVICES (Monitoring feature/device, stand alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified) Per invoice up to $6,000.00 per year SPECIALIZED MEDICAL EQUIPMENT AND SUPPLIES Per itemized invoice S5165 CG HOME ACCESSIBILITY ADAPTATIONS (Repairs) Per itemized invoice S5165 HOME ACCESSIBILITY ADAPTATIONS (Home Modifications) Per itemized invoice V5274 COMMUNICATION AIDS - SPEECH AMPLIFIER, AIDS, COMMUNICATORS (INCLUDING REPAIR AND MAINTENANCE), ASSISTIVE DEVICES Per itemized invoice GN COMMUNICATION AIDS - ONGOING VISUAL-GESTURAL AND FACILITATED COMMUNICATIONS SERVICES $5.40 ¼ hr G9007 NON-traditional communication CONSULTATION $9.00 ¼ hr NON-traditional communication assessment $9.00 ¼ hr
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