Page posted: 8/26/24

Legal authority

Minn. Stat. §256B.85, subd. 17

Comparison of PCA and CFSS

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.

Differences

PCA does not include consultation services. The rest of this page applies to CFSS only. For information about similar PCA services, refer to PCA Manual – Qualified professional (QP) requirements overview.

Definitions

Consultation services provider: A Minnesota Health Care Programs (MHCP) provider that supports people receiving CFSS. Consultation services providers:

Session: An instance of providing covered consultation services to a person. Session time may vary. One session can include multiple tasks. Sessions can be in person or remote.

Overview

All people who use CFSS must select a consultation services provider. All consultation services providers must have a contract with the state to provide consultation services.

This page provides information about the services available through consultation services. For information about provider requirements, refer to CFSS Manual – CFSS consultation services provider requirements.

Covered services

Consultation services providers can only bill for services that are covered and documented on CFSS Consultation Services Sessions Documentation, DHS-6893S or an equivalent form. Consultation services providers bill a flat rate per day, regardless of the number of tasks completed. Not all billable tasks require direct communication with the person. Consultation services provider must use the appropriate modifier for the category of service they provided.

Service set-up and annual CFSS orientation

Service set-up and annual CFSS orientation (no modifier) includes the following tasks:

1. Complete an intake meeting.

2. Educate the person about:

3. Educate the participant’s representative about their role (if applicable).

4. Educate the person and participant’s representative (if applicable) about applicable laws and policies, including but not limited to:

5. Educate the person and participant’s representative (if applicable) about the consultation services provider’s policies, including but not limited to:

6. Provide general information about financial management services (FMS) provider fees and employer-related costs (if applicable).

7. Review the person’s information in MnCHOICES (e.g., support plan, supplemental summary charts, assessment summary).

8. Support the person to write their service delivery plan, to the extent the person desires. For more information, refer to CFSS Manual – PCA/CFSS service delivery plan.

9. Review the person’s service delivery plan and:

10. Complete Consultation Services Provider CFSS Service Delivery Plan Cover Sheet, DHS-6893N (if applicable).

11. Enter data into the consultation services provider’s internal systems.

12. Provide guidance for the person to complete and sign documents, if needed.

Note: Consultation services set-up is covered in a nursing facility if the person:

For more information, refer to CFSS Manual – Eligibility for PCA/CFSS services.

Ongoing consultation and skill development

Ongoing consultation and skill development (TS modifier) includes the following tasks:

Quality assurance support

Quality assurance support (U2 modifier) includes the following tasks:

Other billable tasks

The following tasks are covered and billable within the related category:

The consultation services provider selects the appropriate modifier based on the reason they performed the task. For example, if billing for gathering signatures, the consultation services provider considers the reason:

Non-covered services

CFSS does not cover consultation services if the services are provided:

The following tasks are not covered unless the provider delivers them with covered tasks on the same day:

Consultation services provider’s responsibilities

For information about provider responsibilities, refer to CFSS Manual – CFSS consultation services provider requirements.

Requesting additional sessions

The consultation services provider may request six additional sessions if the person has two sessions remaining. The consultation services provider must submit the request and reason the person needs more sessions to the appropriate entity:

Note: If the person uses CFSS on AC or Elderly Waiver (EW), the case manager or care coordinator can work with the consultation services provider to adjust the number of authorized units if necessary to keep the person’s spending under their AC/EW case mix budget cap.

The consultation service provider must keep documentation of completed sessions on file using CFSS Consultation Services Session Documentation, DHS-6893S or a provider-developed form that contains the same information.

Lead agency’s responsibilities

The lead agency assessor must:

The lead agency case manager/care coordinator must:

DHS’ responsibilities

DHS will: