PROCCODE | MODIFIER | DESCRIPTION | UNIT | MAXIMUM ALLOWANCE | ||
97755 | U9 | Assistive Technology-Assessment | 1/4 hour | $14.44 | ||
T2035 | U9 | Assistive Technology-Transmission (Utility Services) | Month | $50.00 per month | ||
A9279 | U9 | Assistive Technology-(Monitoring feature/device, stand alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified) | Per device | |||
T1016 | U9 | Care Coordination (Case Management) | 1/4 hour | $ 17.00 | ||
T2015 | U9 | Career Planning (Habilitation, prevocational) | per hour | $ 28.00 | ||
97537 | U9 | Community/Work Reintegration-Individual | 1/4 hour | $ 14.05 | ||
97537 | U9 HQ | Community/Work Reintegration-group | 1/4 hour | $ 9.37 | ||
T2019 | U9 | Employment Specialist Services (Habilitation, supported employment waiver) | 1/4 hour | $ 7.49 | ||
T2016 | U9 | Home Support (Residential Habilitation)Level II | Per Diem | $ 301.39 | ||
T2016 | U9 TG | Home Support (Residential Habilitation)Level III- Increased Neurobehavioral | Per Diem | $ 489.61 | ||
T2017 | U9 | Home Support (Residential Habilitation)Level I | 1/4 hour | $ 6.33 | ||
T2017 | U9QC | Home Support (Residential Habilitation)-Remote Support-Monitor Only | 1/4 hour | $ 1.63 | ||
T2017 | U9 GT | Home Support (Residential Habilitation)-Remote Support-Interactive Support | 1/4 hour | $ 6.33 | ||
97535 | U9 | Self Care/Home Management Reintegration-Individual | 1/4 hour | $14.52 | ||
97535 | U9 HQ | Self Care/Home Management Reintegration-Group | 1/4 hour | $ 9.68 | ||
S5102 | U9 | Work Ordered Day Club House (Adult Day Care) | Per Diem | $65.00 | ||
H2023 | U9 | Work Support (Supported Employment)-Individual | 1/4 hour | $6.91 |
MODIFIERS | DESCRIPTIONS | |||||
U9 | Indicates Section 18 Services | |||||
GT | Remote Support-Interactive Support | |||||
QC | Remote Support-Monitor Only | |||||
HQ | Group Setting | |||||
TG | Complex/high tech level of care |
* The effective date of this rate change is retroactive to 4/15/16.
10-144 C.M.R. ch. 101, § III-18
2/27/2017 - filing 2017- 028