Consumer directed community supports (CDCS) service agreements

Page posted: 8/3/26

General service agreement requirements

When authorizing CDCS services:

· The approved screening document that supports the service period on the service agreement must have Y in the CDCS field.

· For Alternative Care (AC) and Elderly Waiver (EW), the required case management procedure code (T2041) must be included on the service agreement, and the units and amount must be within limits for this service.

· For AC and EW, the costs related to required case management and background checks are not included within the total amount used upon completion of the service agreement. This means these costs are not deducted from the overall amount available at the service agreement header.

· For Brain Injury (BI), Community Alternative Care (CAC) and Community Access for Disability Inclusion (CADI), case management must be included on the service agreement using T1016 TF UC and/or T1016 UC (waiver case management).

· There are limitations for additional services that can be authorized in combination with CDCS services on the service agreement for each program type.

· The PCA/CFSS COMPLEX field on the ASA2 screen in the service agreement is mandatory for all service agreement types.

This page explains these requirements in detail. It includes information about:

· CDCS service codes.

· Services allowed with CDCS under AC.

· Services allowed with CDCS under EW.

· Services allowed with CDCS under BI, CAC and CADI.

· CDCS service agreement exception codes.

CDCS service codes

The procedure codes used to identify CDCS services on the service agreement are:

· T2028: Used to authorize all services covered under CDCS.

· T2040: Used to authorize payment for background checks.

· T2041: Used to authorize payment for all activities provided under required case management for AC and EW.

· T1016 TF UC and/or T1016 UC: Used for required case management for BI, CAC and CADI.

CDCS service categories – support plan and payment

T2028 includes the following service categories used by case managers or CDCS support planners in the support plan:

· Personal assistance.

· Treatment and training.

· Environmental modifications – home modifications.

· Environmental modifications – vehicle modifications.

· CDCS support planner.

· Financial management services.

· Individual-directed goods and services.

· Community integration and support.

For information about service category codes providers use to bill for service categories approved in the CDCS support plan, refer to MMIS LTSS Manual – CDCS claims.

Services allowed with CDCS under AC

A person who uses CDCS through AC can receive:

· T2028 (CDCS).

· T2040 (background checks).

· T2041 (required case management).

· T1016 (conversion case management, which provides relocation assistance when the person is admitted to a nursing facility; refer to MMIS LTSS Manual – AC conversion case management).

Home care in combination with AC

Use T2028 (CDCS) to authorize all services and costs for services provided to people on AC using CDCS, including all home care and personal care services. When a person’s support plan includes these services, the cost is combined under the T2028 (CDCS) authorization. You do not use the home care and personal care assistance (PCA)/Community First Services and Supports (CFSS) procedure codes for authorization, billing or payment.

The total dollar amount authorized cannot exceed the CDCS budget cap on the last approved screening document and on the AC service agreement at the header. The monthly CDCS budget cap is on the CDCS AMOUNT field on the ALT4 screen of the screening document. This amount is multiplied times the number of months that are part of the AC service agreement header date span. The total CDCS budget cap for the service agreement timeline is on the CAP AMT field of the ASA1 screen of the service agreement.

Services allowed with CDCS under EW

A person who uses CDCS though EW can also be approved to received waiver case management and state funded home care or PCA/CFSS services that are not extended services. For a list of services, refer to Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

Costs of approved extended home care and PCA/CFSS services must be included within the approved CDCS line item on the service agreement.

For people enrolled in managed care for Minnesota Senior Health Options (MSHO) or Minnesota Senior Care Plus (MSC+), the costs of all home care services covered under the managed care program should still be documented on the MMIS service agreement under the X5609 code.

The total dollar amount authorized for all services cannot exceed the CDCS budget cap on the last approved screening document and on the EW service agreement at the header. The monthly CDCS budget cap is on the CDCS AMOUNT field on the ALT4 screen of the screening document. This amount is multiplied times the number of months that are part of the service agreement header date span. The total CDCS budget cap for the service agreement timeline is on the CAP AMT field of the ASA1 screen of the service agreement.

Moving Home Minnesota (MHM) and CDCS with EW

A person who uses CDCS through EW can also receive MHM services. For more information, refer to MMIS LTSS Manual – MHM services.

The costs of these MHM services are not applied against the CDCS budget cap.

Services allowed with CDCS under BI, CAC and CADI

A person who uses CDCS though BI, CAC or CADI can also be approved to received waiver case management and state funded home care or PCA/CFSS services that are not extended services. Costs of approved extended home care and PCA/CFSS services must be included within the approved CDCS line item on the service agreement.

For people enrolled in a managed care program of MSHO/MSC+ or SNBC, the costs of all home care services covered under the managed care program should still be documented on the MMIS service agreement under the code of X5609.

MMIS totals the cost of all services authorized on the service agreement. This calculated dollar amount will appear in the TOT AUTH AMT field on the ASA1 screen on the service agreement.

CDCS service agreement exception codes (i.e., edits)

CDCS service agreement exception codes ensure you:

· Indicate CDCS on the screening document before you enter CDCS line items on the service agreement.

· Use specific service codes when the person chooses CDCS.

· Authorize a total amount for CDCS services that is under the CDCS budget cap for AC and EW.

· Include required case management.

· Authorize a total amount for required case management for AC and EW that is under the cap amount for required case management and is not included in the total cap amount on the ASA1 screen of the service agreement.

Exception codes when exceeding the AC or EW budget for death or nursing facility admission

AC or EW service agreements that include a line item for T2028 (CDCS) allow the person to use their budget flexibly during a 12-month period.

You may need to exceed the total allowable cap applied to AC and EW service agreements when you close a program because the person died or was admitted to a nursing facility for 30 or more days. MMIS will bypass exception codes 672 (i.e., total authorized amount exceeds the cap amount) and/or 452 (i.e., required case management cap exceeded) when you reduce the header end date for either of these reasons.

When you reduce the header end date to close the program and the total authorized amount now exceeds the total cap amount available:

1. Reduce the line items end date(s) to reflect the new header end date. This date can be earlier than but not later than the header end date.

2. Add or reduce units and total amounts on line items, as applicable.

3. Add new line items, as applicable.

4. Press F9 to display exception codes. Note:

· MMIS bypasses exception code 672.

· MMIS adds reason code 672 (i.e., this service agreement total amount is approved to exceed the total cap amount) to the ASA2 screen. The reason code is protected and will turn red to indicate an error if you try to add it to the ASA2 screen manually. MMIS does not add a message to the person, case manager and provider letters for reason code 672.

· MMIS bypasses exception code 452 (i.e., total required case management costs exceeds cap) if the services do not exceed the 12-month total cap.

· MMIS posts exception code 452 if the 12-month total required case management cap is exceeded. In this case, you must reduce the required case management units to resolve this exception code.

5. Resolve exception codes.

6. Press F3 to save and exit the service agreement.

Note: If you make other changes to the service agreement after reducing the header end date, exception codes 672 and/or 452 may post, depending on the changes you made. These exception codes ensure you do not make additional unallowed changes to the service agreement after you have completed the initial change to reduce the approved timeline.

Other CDCS exception codes (all programs)

Exception code	Title	Description
241	Provider type/service conflict Status: 4 (suspend)	MMIS will post this exception code if you use fiscal support entity (FSE) provider numbers on the line item for T2028 or T2040 that begin on or after July 1, 2019. FSEs are provider type 18 in the provider subsystem. You must use financial management services (FMS) providers for line items that begin on or after July 1, 2019. FMS providers are provider type 38 in the provider subsystem.
363	Procedure/modifier conflict Status: 4 (suspend)	MMIS will post this exception code if you enter procedure code T2028 on a service agreement using a modifier.
440	Excluded time field is blank or invalid Status: 4 (suspend)	MMIS will post this exception code if you enter an invalid code or leave the excluded time field blank on a BI, CAC or CADI service agreement. You must enter a value in the excluded time field on a BI, CAC or CADI service agreement. This field is not required for AC or EW service agreements and can be forced if it posts to an AC or EW service agreement when the field is left blank.
443	CDCS not authorized Status: 4 (suspend)	MMIS will post this exception code when you add T2028 to the service agreement and the CDCS field on the screening document is N. If the CDCS field on the last approved screening document was mistakenly entered as N, delete that screening document and enter a new screening document with the correct value.
444	CDCS/other service conflict Status: 4 (suspend)	MMIS will post this exception code if the cost of a service listed the service agreement will be included within the CDCS approved amount. It indicates that procedure code T2028 (CDCS) conflicts with another service listed on a BI, CAC or CADI service agreement.
445	Service not allowed with CDCS Status: 4 (suspend)	MMIS will post this exception code if the cost of a service listed the service agreement will be included within the CDCS approved amount. It indicates that procedure code T2028 (CDCS) conflicts with another service listed on an AC or EW service agreement.
447	RCM without CDCS Status: 4 (suspend)	MMIS will post this exception code if an approved line item for T2028 (CDCS) is not on the same AC or EW service agreement as T2041 (required case management [RCM]). You must enter a line item for T2028 (CDCS) and change the status to A (approved). MMIS will also post this exception code if an approved line item for T2041 (RCM) is not on the same AC or EW service agreement as T2028 (CDCS). You must enter a line item for T2041 (RCM) and change the status to A (approved).
452	RCM cap exceeded Status: 4 (suspend)	MMIS will post this exception code if the total sum of all line items for T2041 (RCM) exceed the RCM budget cap. You must reduce the line item(s) so the total amount does not exceed the RCM budget cap. MMIS will bypass exception code 452 if the service does not exceed the 12-month total cap when the header period is less than 12 months when closing AC or EW.
672	Total authorized amount exceeded Status: 4 (suspend)	MMIS will post this exception code if the total authorized amounts for the line items exceed the CDCS EW or AC budget cap (i.e., total cap amount field). MMIS will not post exception code 672 if the total authorized amounts exceed the CDCS EW or AC budget cap when closing AC or EW. You must reduce the header end date to show the new exit date you will use on the screening document to close AC or EW.

Additional resources

Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF)
MMIS LTSS Manual – AC conversion case management
MMIS LTSS Manual – CDCS claims
MMIS LTSS Manual – MHM services