Consumer directed community supports (CDCS) claim payments

Page posted: 8/3/26

Providers use modifiers on claims to identify the services provided under T2028 (i.e., CDCS services). When preparing to bill, the provider must ensure the claim form line includes one of the following modifiers.

Table 1: CDCS services

CDCS service name	Procedure code	Modifier
CDCS: Personal care assistance	T2028	U1
CDCS: Treatment and training	T2028	U2
CDCS: Environmental modifications and provisions	T2028	U3
CDCS: Self-direction support activities	T2028	U4
CDCS: Self-direction support activities, support planner	T2028	U8
CDCS: Financial management services, unbundled	T2028	U5
CDCS Community integration and support, unbundled	T2028	U6
CDCS: Environmental modifications – vehicle modifications, unbundled	T2028	UA
CDCS: Environmental modifications – home modifications, unbundled	T2028	UB
CDCS: Support planner, unbundled	T2028	UC
CDCS: Individual directed goods and services, unbundled	T2028	U9

Payments from the claims using T2028 with modifiers will decrease the dollar amount from the service agreement line item for T2028.

Providers must use:

· T2040 on the claim form to bill for background checks.

· T2041 on the claim form to bill for required case management.

Payments for T2028 and T2041 apply toward the Special Income Standard (SIS)/Elderly Waiver (EW) waiver obligation.

Claim modifier 76

Claim modifier 76 allows payment for multiple services provided on the same date or date span. When a provider will have more than one claim for the same date(s) using procedure code T2028, they must:

· Use a modifier as described above in the MOD1 field of the claim line item.

· Use modifier 76 in the MOD2 field of the claim line item.

When the provider uses modifier 76, MMIS will not treat the claim(s) as a duplicate of the initial claim.

Additional resources

CDCS Policy Manual
MHCP Provider Manual Home
MHCP Provider Manual – FMS