HCBS service agreements with PCA complex (enhanced rate), CFSS complex (enhanced rate/budget) or PCA/CFSS shared services

Page posted: 8/3/26
Page updated: 11/10/26

This page provides information about home and community-based services (HCBS) waiver and Alternative Care (AC) service agreements that include:

Note: DHS is in the process of replacing PCA with CFSS. For more information about this transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS.

PCA/CFSS complex

In MMIS, the field that indicates a person is assessed as eligible or not eligible for PCA/CFSS services at an enhanced rate/budget is called “PCA/CFSS complex.” A person who is eligible for 10 or more hours of state plan PCA/CFSS is eligible for the enhanced rate/budget.

You must complete fields indicating if a person is or is not eligible for the enhanced rate/budget in both the LTC screening document and the service agreement. For instructions, refer to CFSS Manual – PCA, CFSS and CSG enhanced rate/budget.

PCA/CFSS shared services

PCA/CFSS shared services are an option for PCA/CFSS services provided in the same setting, at the same time, by the same PCA/CFSS worker, through the same PCA/CFSS provider agency or financial management services (FMS) provider for two or three people who choose to have services delivered in this manner.

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

PCA authorization instructions

To authorize shared PCA services on a waiver service agreement:

1. Use either:

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

Notes:

CFSS authorization instructions

The SHR (shared care) field will automatically populate a Y on the ASA3 screen at the T1019 CFSS 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 modifier 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 modifier 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 modifiers 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