Code | Per Diem Rate | Description |
S5102 | $114.97 | Skills training and development, per diem (community program, low need) |
S5102-TF | $129.33 | Skills training and development per diem, intermediate level of care (community program, moderate need) |
S5102-TG | $167.85 | Skills training and development, per diem, complex/high tech level of care (community program, high need) |
S5102-U1 | $121.64 | Skills training and development, per diem (nursing facility, one to two or one to three staffing level) |
S5102-U2 | $219.06 | Skills training and development per diem (nursing facility, one to one staffing level) |
S5102-22 | $100.60 | Skills training and development, per diem, unusual procedural service, when the service(s) provided is greater than that usually listed for the listed procedure (supplemental staffing for nursing facility residents in community day habilitation) |
S5101 | $57.48 | Skills training and development, half per diem (community program, low need) |
S5101-TF | $64.66 | Skills training and development, half per diem, intermediate level of care (community program, moderate need) |
S5101-TG | $83.92 | Skills training and development, half per diem, complex/high tech level of care (community program, high need) |
S5101-U1 | $60.72 | Skills training and development, half per diem (nursing facility, one to two or one to three staffing level) |
S5101-U2 | $109.53 | Skills training and development, half per diem (nursing facility, one to one staffing level) |
S5101-22 | $50.30 | Skills training and development, half per diem, unusual procedural service, when the service(s) provided is greater than that usually listed for the listed procedure (supplemental staffing for nursing facility residents in community day habilitation) |
Code | Per Diem Rate | Description |
S5101 | $57.48 | Skills training and development, half per diem (community program, low need) |
S5101-TF | $64.66 | Skills training and development, half per diem, intermediate level of care (community program, moderate need) |
S5101-TG | $83.92 | Skills training and development, half per diem, complex/high tech level of care (community program, high need) |
S5101-U1 | $60.72 | Skills training and development, half per diem (nursing facility, one to two or one to three staffing level) |
S5101-U2 | $109.53 | Skills training and development, half per diem (nursing facility, one to one staffing level) |
S5101-22 | $50.30 | Skills training and development, half per diem, unusual procedural service, when the service(s) provided is greater than that usually listed for the listed procedure (supplemental staffing for nursing facility residents in community day habilitation) |
Code | Quarter Per Diem | Description |
S5100-U5 | $28.74 | Skills training and development, quarter per diem (community program, low need) |
S5100-U5-TF | $32.33 | Skills training and development, quarter per diem, intermediate level of care (community program, moderate need) |
S5100-U5-TG | $41.96 | Skills training and development, quarter per diem, complex/high tech level of care (community program, high need) |
Code | One-time Only | Description |
S5105 | $2000.00 | Admission Services (one-time only on or after the 45th day of service) |
S5105-KZ | $12,000.00 | Re-engagement Services (one-time only on or after the 45th day of service) |
Code | Per 15-minute Rate | Description |
T1019 | $7.57 | ISS - Direct Care/Program Staff |
T1019-TD | $21.68 | ISS - Registered Nurse (RN) |
T1019-TE | $14.39 | ISS - Licensed Practical Nurse (LPN) |
Code | Per One-Way Trip | Description |
T2003 | $28.56 | Non-wheelchair (ambulatory) transportation |
T2003-U6 | $34.98 | Wheelchair transportation (one-way trip) |
T2003-U7 | $34.98 | Monitor Transportation (one-way trip) |
101 CMR, § 348.03