ABI Reimbursement Schedule
Adult Brain Injury Program Provider Manual
ABI Reimbursement Schedule
(No more than two rehabilitation services may be authorized for the same time period for each participant)
| Service Code | Description | Unit | Rate | Cap |
|---|---|---|---|---|
| 0107 | Consultation Visit | Flat Fee | $60.00 | |
| Adjustment Counseling - Individual | 26 one-hour sessions, lifetime 104 units | 26 one-hour sessions, lifetime 104 units | 26 one-hour sessions, lifetime 104 units | |
| 0010 | Individual Adjustment Counseling – Psychologist | 15 minutes | $22.00 | 104 |
| 0011 | Individual Adjustment Counseling – Social Work | 15 minutes | $20.00 | 104 |
| 0012 | Individual Adjustment Counseling – LPC | 15 minutes | $20.00 | 104 |
| Cognitive/Behavioral | ||||
| 0005 | Neuropsychological Evaluation and Consultation | Flat fee | $625.00 | 2 per lifetime when medically justified |
| Community Integration | Lifetime limit of 1,000 hours or 4000 units | Lifetime limit of 1,000 hours or 4000 units | Lifetime limit of 1,000 hours or 4000 units | |
| 0004 | Transitional Home and Community Support | 15 minutes | $12.50 | 4000 |
| Educational/Vocational | See each individual limit | See each individual limit | ||
| 108 | Pre-Vocational/Pre-Employment Training | 3-hour day | $74.00 | Lifetime limit of 180 units (3 or 6 hour day) |
| 0007 | Special Instruction | 15 minutes | $10.50 | Lifetime limit of 250 hours or 1000 units |
| 0008 | Pre-Vocational/Pre-Employment Training | 6-hour day | $143.00 | Lifetime limit of 180 units (3 or 6 hour day) |
| 0009 | Supported Employment/Long Term Follow Along | 15 minutes | $12.50 | Covers a maximum of 25% of work hours, not to exceed 40 hr. work week. |
| Interpreter | Fees based on units and time | Fees based on units and time | Fees based on units and time | |
| 0105 | Telephone Interpreter | 15 minutes | $8.00 | (1) Unit = 15 minute minimum |
| 0105H | In-Home Interpreter – 2 hour minimum | 15 minutes | $12.00 | (1) Unit = 15 minute with 2 hour minimum |