Medically Complex Children and Youth (MCCY) Program Service Codes | ||||
|---|---|---|---|---|
PROVIDER TYPE | PROCEDURE CODE | MODIFIER | DESCRIPTION | RATE |
94 | T1000 | N/A | Private Duty Nursing (PDN) - (1) 15 min unit | Updated annually |
PRESCRIBED PEDIATRIC EXTENDED CARE | ||||
97 | T1025 | N/A | Prescribed Pediatric Extended Care – (1) unit per day | Updated annually |
PERSONAL CARE | ||||
PROVIDER TYPE | PROCEDURE CODE | MODIFIER | DESCRIPTION | RATE |
26 | T1019 | EP | Personal Care Aide (PCA) - (1) 15 min unit | Updated annually |
T1019 | TF EP | Advanced Personal Care Aide (APC) - (1) 15 min unit | Updated annually | |
T1001 | EP | Authorized RN Visit (ARN) - (1) unit per visit | Updated annually | |
HOME HEALTH | ||||
PROVIDER TYPE | PROCEDURE CODE | MODIFIER | DESCRIPTION | RATE |
58 | G0156 | EP | Home Health Aide - (1) per visit | Updated annually |
G0299 | EP | Skilled Nurse Visit - RN (SNV) - (1) per visit | Updated annually | |
G0300 | EP | Skilled Nurse Visit - LPN (SNV) - (1) per visit | Updated annually | |
CASE MANAGEMENT | ||||
PROVIDER TYPE | PROCEDURE CODE | MODIFIER | DESCRIPTION | RATE |
18, 20, 24, 50, 51, 54, 55 | T1016 | EP | Case Management - Child calendar month initial visit | Updated annually |
T1016 | EP TS | Case Management - Child subsequent calendar months | Updated annually | |
MEDICALLY COMPLEX ADULT WAIVER (MCAW) SERVICE CODES | ||||
|---|---|---|---|---|
PRIVATE DUTY NURSING | ||||
PROVIDER TYPE | PROCEDURE CODE | MODIFIER | DESCRIPTION | |
94 | T1000 | U5 | Private Duty Nursing (PDN) - (1) 15 min unit | Updated annually |
T1000 | SC | Private Duty Nursing Exceptions (PDN) - (1) 15 min unit | Updated annually | |
PERSONAL CARE | ||||
PROVIDER TYPE | PROCEDURE CODE | MODIFIER | DESCRIPTION | RATE |
26 | T1019 | N/A | State plan Personal Care Aide (PCA) - (1) 15 min unit | Updated annually |
T1019 | TF | State plan Advanced Personal Care Aide (APC) - (1) 15 min unit | Updated annually | |
T1001 | N/A | State plan Authorized RN Visit (ARN) - (1) unit per visit | Updated annually | |
S5125 | U5 | Attendant Care (WAC) - (1) 15 min unit | Updated annually | |
SUPPLIES | ||||
PROVIDER TYPE | PROCEDURE CODE | MODIFIER | DESCRIPTION | RATE |
62 | T2028 | U5 NU | Specialized supplies | Wholesale plus 20% |