PROCEDURE MAXIMUM ALLOWANCE DESCRIPTION CODE Effective 7/1/18 HOME SUPPORT (Habilitation, residential, waiver)- Family-Centered T2016 UQ U5 $76.64 Per diem Support-Four members served- T2016 UQ TG HOME SUPPORT (Habilitation, residential, waiver)- Family-Centered $200.48 Per diem U5 Support-Four members served- increased level of support HOME SUPPORT (Habilitation, residential, waiver)- Family-Centered T2016 UR U5 $68.36 Per diem Support-Five or more members served T2016 UR TG HOME SUPPORT (Habilitation, residential, waiver)- Family-Centered $188.86 Per diem U5 Support-Five or more members served- increased of support SHARED LIVING SHARED LIVING (Foster Care, adult)-Shared Living Model-One S5140 $156.00 Per diem member served SHARED LIVING (Foster Care, adult)-Shared Living Model-One S5140 TG $226.88 Per diem member served- increased level of support SHARED LIVING (Foster Care, adult)-Shared Living Model-Two S5140 UN $78.02 Per diem members served SHARED LIVING (Foster Care, adult)-Shared Living Model-Two S5140 UN TG $148.87 Per diem members served- increased level of support H2023 WORK SUPPORT (supported employment)-Individual $8.46 ¼ hr H2023 SC WORK SUPPORT (supported employment)- with Medical Add On $9.89 ¼ hr UN WORK SUPPORT (supported employment)-Group 2 members served up to $4.24 per ¼ hr H2023 UP WORK SUPPORT (supported employment)-Group 3 members served up to $2.82 per ¼ hr H2023 UQ WORK SUPPORT (supported employment)-Group 4 members served up to $2.12 per ¼ hr UR WORK SUPPORT (supported employment)-Group 5 members served up to $1.69 per ¼ hr H2023 US WORK SUPPORT (supported employment)-Group 6 members served up to $1.41 per ¼ hr CAREER PLANNING (Habilitation, prevocational) $34.29 hr
PROCEDURE CODE DESCRIPTION MAXIMUM ALLOWANCE Effective 7/1/18 T2016 UQ U5 HOME SUPPORT (Habilitation, residential, waiver)- Family-Centered Support-Four members served- $76.64 Per diem T2016 UQ TG U5 HOME SUPPORT (Habilitation, residential, waiver)- Family-Centered Support-Four members served- increased level of support $200.48 Per diem T2016 UR U5 HOME SUPPORT (Habilitation, residential, waiver)- Family-Centered Support-Five or more members served $68.36 Per diem T2016 UR TG U5 HOME SUPPORT (Habilitation, residential, waiver)- Family-Centered Support-Five or more members served- increased of support $188.86 Per diem SHARED LIVING S5140 SHARED LIVING (Foster Care, adult)-Shared Living Model-One member served $156.00 Per diem S5140 TG SHARED LIVING (Foster Care, adult)-Shared Living Model-One member served- increased level of support $226.88 Per diem S5140 UN SHARED LIVING (Foster Care, adult)-Shared Living Model-Two members served $78.02 Per diem S5140 UN TG SHARED LIVING (Foster Care, adult)-Shared Living Model-Two members served- increased level of support $148.87 Per diem H2023 WORK SUPPORT (supported employment)-Individual $8.46 ¼ hr H2023 SC WORK SUPPORT (supported employment)- with Medical Add On $9.89 ¼ hr UN WORK SUPPORT (supported employment)-Group 2 members served up to $4.24 per ¼ hr H2023 UP WORK SUPPORT (supported employment)-Group 3 members served up to $2.82 per ¼ hr H2023 UQ WORK SUPPORT (supported employment)-Group 4 members served up to $2.12 per ¼ hr UR WORK SUPPORT (supported employment)-Group 5 members served up to $1.69 per ¼ hr H2023 US WORK SUPPORT (supported employment)-Group 6 members served up to $1.41 per ¼ hr CAREER PLANNING (Habilitation, prevocational) $34.29 hr
c3s021.docx