DHS is in the process of replacing personal care assistance (PCA) and the Consumer Support Grant (CSG) with Community First Services and Supports (CFSS). For more information about this transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS.

For a Medicaid Management Information System (MMIS) transition summary, refer to DSD MMIS Reference Guide – MMIS transition from PCA and CSG to CFSS.

Similarities

There are no similarities between PCA and CFSS on the ASA3 screen for financial management services (FMS) provider fees.

Differences

In PCA, a person does not use an FMS provider. The ASA3 screen for FMS provider fees only applies to CFSS.

In PCA, the county/tribal nation used the UA modifier to authorize PCA worker supervision/training (T1019 – UA). In CFSS, the county/tribal nation uses the UA modifier on the FMS provider fee (T2040 – UB and UA) line.

The county/tribal nation enters lines for the person’s specific services on the ASA3 screen. This page describes how to enter an FMS provider fee (T2040 – UB and UA) line for a person who uses the CFSS budget model. The county/tribal nation cannot enter more than one FMS provider fee line with overlapping dates. For information and instructions about other ASA3 line types, refer to DSD MMIS Reference Guide – ASA3 screen overview.

CFSS budget model

For a person who uses the CFSS budget model, the county/tribal nation enters an FMS provider fee (T2040 – UB and UA) line. If the county/tribal nation does not enter an FMS provider fee (T2040 – UB and UA) line, MMIS posts an exception code the county/tribal nation must resolve.

CFSS agency model

For a person who uses the CFSS agency model, the county/tribal nation does not enter an FMS provider fee (T2040 – UB and UA) line. If the county/tribal nation enters an FMS provider fee (T2040 – UB and UA) line, MMIS posts an exception code the county/tribal nation must resolve.

If a person who uses the CFSS agency model purchases goods and services, their goods and services (T5999 – U9) line includes the FMS provider fee.

In the optional LI COMMENTS field, the county/tribal nation enters additional clarifying information, if desired. This comment appears in the person’s letter and the provider’s letter.

In the PROC field, the county/tribal nation enters the FMS provider fee procedure code (T2040) for all people who use the CFSS budget model.

Note: MMIS posts an exception code the county/tribal nation must resolve if:

1. The county/tribal nation enters a CFSS SA without an FMS provider fee (T2040 – UB and UA) line, and the person’s SA has any lines with the budget model modifier (UB) with overlapping dates.

2. The county/tribal nation enters an FMS provider fee (T2040 – UB and UA) line, and the person’s SA has any lines with the agency model modifier (U9) with overlapping dates.

In the MOD1-4 field, the county/tribal nation enters both the modifiers UB and UA to provide additional information needed for authorization and billing.

In the START/END DT fields, the county/tribal nation enters start and end dates in MMDDYY format. Start and end dates indicate when the line starts and ends. The dates must be within the agreement start and end dates (AGMT START/END DT fields) on the ASA1 screen.

The county/tribal nation leaves the REQ RATE/UNIT field blank. If the county/tribal nation edits this field, MMIS posted an exception code the county/tribal nation must resolve.

The county/tribal nation leaves the REQ TOT UNITS field blank. If the county/tribal nation edits this field, MMIS posted an exception code the county/tribal nation must resolve.

In the REQ TOT AMT field, the county/tribal nation enters the total FMS provider fee for the SA listed in the person’s approved CFSS Individual Service Delivery Plan, DHS-6893P.

In the PROV NBR field, the county/tribal nation enters the provider number for the person’s FMS provider.

If the person has selected a provider, the county/tribal nation enters the FMS provider’s National Provider Identifier (NPI) number or Unique Minnesota Provider Identifier (UMPI) number.

The provider number entered on the FMS provider fee (T2040 – UB and UA) line must match the provider number entered on the following line types with overlapping dates, if applicable:

If the county/tribal nation enters a provider number that does not match the provider number entered in any of the above lines with overlapping dates, MMIS posts an exception code the county/tribal nation must resolve.

If the person has not selected a provider, the county/tribal nation enters:

For more information, refer to DSD MMIS Reference Guide – Finalize a type B service agreement for PCA/CFSS.

Find a provider number in MMIS

If the person’s service delivery plan does not list the provider number, refer to Instructions for Completing and Entering the LTCC Screening Document and Service Agreement into MMIS, DHS-4625 (PDF).

MMIS auto-populates the PROV NAME field when the county/tribal nation presses function key F9. This field lists the provider name based on the provider number the county/tribal nation enters in the PROV NBR field. The county/tribal nation cannot edit this field.

MMIS auto-populates the SHR field. If the county/tribal nation edits this field, MMIS overwrites their entry.

The county/tribal nation cannot edit the FREQ field.

In the RSN CD field, the county/tribal nation enters legal notice language to add to the SA when needed. If the county/tribal nation makes changes specific to FMS provider fees, they enter the appropriate reason codes in this field. For more information, refer to DSD MMIS Reference Guide – ASA3 screen overview.

MMIS reason code text

For a list of MMIS reason codes, refer to DSD MMIS Reference Guide – Type B home care service agreement MMIS reason codes.

If the county/tribal nation needs to enter more lines, they press function key F11 to display the next blank line. MMIS displays only two lines per page.

After the county/tribal nation enters all lines, they press a transmit key to advance to the AHC1 screen.