Home and community-based services (HCBS) service agreements with personal care assistance (PCA) complex (enhanced rate) or PCA shared services

Page posted: 8/3/26

This page provides information about waiver and Alternative Care (AC) service agreements that include:

Note: DHS is working to add information about Community First Services and Supports (CFSS) to this page.

PCA complex

In MMIS, the field that indicates a person is assessed as eligible or not eligible to be approved for PCA services at an enhanced rate is called “PCA complex.” A person who is eligible for 10 or more hours of state plan PCA is eligible to be approved for the enhanced rate. You must complete fields indicating if a person is or is not eligible for the enhanced rate in both MMIS and the LTC screening document.

For instructions, refer to CFSS Manual – PCA, CFSS and CSG enhanced rate/budget.

PCA shared services

PCA shared services are an option for PCA services provided in the same setting, at the same time, by the same PCA worker, for two or three people who choose to have services delivered in this manner.

If the person uses PCA Choice (i.e., self-directed PCA), the same PCA Choice provider provides all of the person’s shared care (when the person chooses that option). The person can select the shared care option at any time by contacting their waiver or AC case manager.

For policy information, refer to CFSS Manual – Shared service option for PCA/CFSS.

Authorization instructions

To authorize shared PCA services on a waiver service agreement:

1. Use either T1019 (PCA services), T1019 with modifier TG (PCA complex), T1019 TG UC (waiver extended PCA complex), or T1019 with modifier UC (extended PCA), on the line item.

2. Enter Y in the SHR (shared care) field on the ASA3 screen at the PCA line item.

To authorize shared PCA services on an AC service agreement:

1. Use T1019 (PCA services) or T1019 TG (PCA complex services) on the line item.

2. Enter Y in the SHR (shared care) field on the ASA3 screen at the PCA line item.

Provider letters

When the SHR field is Y on the T1019 line with no modifiers on the line item, MMIS will place this message on the provider letter:
“For MA PCA: Shared care option chosen, provider may bill one of the following codes: T1019, T1019 TT, or T1019 HQ with applicable modifier combination. Review the MHCP Provider Manual for billing instruction.”

When the SHR field is Y on the T1019 with TG line item, MMIS will place this message on the provider letter:
“For MA PCA: Shared care option chosen, provider may bill one of the following codes: T1019 TG, T1019 TG TT, or T1019 TG HQ with applicable modifier combination. Review the MHCP Provider Manual for billing instruction.”

When the SHR field is Y on the T1019 with UC line item, MMIS will place this message on the provider letter:
“For extended PCA: Shared care option chosen, provider may bill one of the following codes: T1019 UC, T1019 TT UC, or T1019 HQ UC with applicable modifier combination. Review the MHCP Provider Manual for billing instruction.”

When the SHR field is Y on the T1019 with TG UC line item, MMIS will place this message on the provider letter:
“For extended PCA: Shared care option chosen, provider may bill one of the following codes: T1019 TG UC, T1019 TG TT UC, or T1019 TG HQ UC with applicable modifier combination. Review the MHCP Provider Manual for billing instruction.”

For more information about provider billing, refer to the billing section of MHCP Provider Manual – PCA services.

Additional resources

CFSS Manual – PCA, CFSS and CSG enhanced rate/budget
CFSS Manual – Shared service option for PCA/CFSS
MHCP Provider Manual – PCA services