11

T2028

U2

09

CDCS - Treatment and training

10/01/2004

22

T2028

U3

09

CDCS - Environmental modifications and provisions

10/01/2004

33

T2028

U4

09

CDCS - Self direction support activities

10/01/2004

44

T1019

TT

UC

16

Extended shared personal care services 1:2

11/01/2004

55

T1019

HQ

UC

16

Extended shared personal care services 1:3

11/01/2004

66

S5135

U9

16

Behavioral programming by aide

11/01/2004

04/30/2013

77

S5135

UA

16

BI night supervision

11/01/2004

88

S5135

UB

16

24-hour emergency assistance (15 minutes)

11/01/2004

12/31/2013

99

S5136

UB

08

24-hour emergency assistance (day)

11/01/2004

12/31/2013

100

S5100

TF

16

Adult day service bath

11/01/2004

110

T1002

TT

UC

16

RN, regular, extended 1:2

11/01/2004

111

T1003

TT

UC

16

LPN, regular, extended 1:2

11/01/2004

112

S9131

TF

UC

29

Extended physical therapy assistant

11/01/2004

113

S9129

TF

UC

29

Extended occupational therapy assistant

11/01/2004

114

T1002

TG

UC

16

RN, complex, extended

11/01/2004

115

T1003

TG

UC

16

LPN, complex, extended

11/01/2004

116

T1002

TT

16

RN, regular 1:2

11/01/2004

117

T1002

UC

16

RN, regular, extended 1:1

11/01/2004

118

T1002

TG

16

RN, complex

11/01/2004

119

T1003

UC

16

LPN, regular, extended 1:1

11/01/2004

120

T1003

TT

16

LPN, regular 1:2

11/01/2004

121

T1003

TG

16

LPN, complex

11/01/2004

122

T1019

TT

16

Personal care services (PCA) 1:2

11/01/2004

123

T1019

16

Personal care services (PCA) 1:1

11/01/2004

124

T1019

HQ

16

Personal care services (PCA) 1:3

11/01/2004

125

T2023

HA

HE

18

MH-TCM, child, face-to-face

01/01/2004

126

T2023

HE

U4

18

MH-TCM, adult, telephone

01/01/2004

127

T2023

HE

HW

18

MH-TCM, adult, face-to-face by state staff

01/01/2004

12/31/2007

128

T2023

HE

HW

U4

18

MH-TCM, adult, telephone by state staff

01/01/2004

12/31/2007

129

T2023

U3

18

CW-TCM, face-to-face

01/01/2004

130

T2023

U3

U4

18

CW-TCM, telephone

01/01/2004

131

T2023

U1

18

VA/DD-TCM, face-to-face

01/01/2004

132

T2023

U1

U4

18

VA/DD-TCM, telephone

01/01/2004

135

T1005

TG

16

Crisis respite, specialized

11/01/2004

140

S5126

TG

08

DD, in home family support (day)

11/01/2004

12/31/2013

141

H0040

HW

08

Assertive Community Treatment (ACT) by state staff

07/01/2004

12/31/2007

142

H0019

08

Children's residential treatment

07/01/2004

143

H0019

HW

08

Intensive Residential Rehab. Treatment (IRT) by state staff

07/01/2004

12/31/2007

145

S9484

HM

11

Crisis assessment, intervention and stabilization, non-residential, ind. by rehab. worker

01/01/2004

146

S9484

HQ

11

Crisis assessment, intervention and stabilization, non-residential, group

01/01/2004

91155306

X5265

28

Transportation

01/01/1999

09/30/2006

91155312

X5291

18

Residential care services

01/01/1999

09/30/2006

91155315

X5294

28

Extended transportation

01/01/1999

09/30/2006

91155324

X5363

18

Foster care, corporate

01/01/2000

09/30/2006

91155325

X5400

26

DD county screening, MA elig

01/01/1999

09/30/2006

91155326

X5410

17

Day program, supported employment

01/01/1999

09/30/2006

91155327

X5411

22

Day program, supported employment

01/01/1999

09/30/2006

91155328

X5412

08

Day program, supported employment

01/01/1999

09/30/2006

91155331

X5415

17

MR, adult supported living services

01/01/1999

09/30/2006

91155332

X5416

08

MR, adult supported living services

01/01/1999

09/30/2006

91155352

X5467

12

Extended home health medical supplies/equipment

01/01/1999

09/30/2006

91155353

X5476

16

Case management

01/01/1999

09/30/2006

91155358

X5484

17

Respite care, out of home

01/01/1999

09/30/2006

91155362

X5491

16

Case management, paraprofessional

01/01/1999

09/30/2006

91155364

X5502

06

Consumer education and training

01/01/1999

09/30/2006

91155365

X5503

11

Consumer directed community support

01/01/1999

06/30/2005

91155366

X5504

08

Consumer directed community support

01/01/1999

06/30/2005

91155378

X5590

17

Independent Living Skills counseling

01/01/1999

09/30/2006

91155381

X5593

17

Independent Living Skills group therapy

01/01/1999

09/30/2006

91155386

X5601

28

Extended transportation

01/01/1999

09/30/2006

91155387

X5602

14

Extended transportation

01/01/1999

09/30/2006

91155388

X5603

09

Extended transportation - extra attendant

01/01/1999

09/30/2006

91155396

X5630

16

MR Preadmission screening - 15 min

01/01/1999

09/30/2006

91155398

X5632

16

MH preadmission screening

01/01/1999

91155400

X5639

17

PASARR MH diag asses Masters

01/01/1999

91155401

X5640

17

PASARR MH diag asses PhD

01/01/1999

91155419

X5671

12

Assistive technology

01/01/1999

09/30/2006

91155422

X5674

11

Specialist service

01/01/1999

09/30/2006

91155425

X5679

22

DT&H, waiver, non-pilot

01/01/1999

09/30/2006

91155438

99450

16

Life/disability evaluation: Face-to-face LTCC assessment under age 65

07/01/2001

03/31/2008

91155439

X5398

18

MR, adult supported living services

02/01/2000

09/30/2006

91155440

T1016

16

Relocation Service Coordination (RSC-TCM)

07/01/2001

08/31/2008

91155443

H0018

08

Crisis stabilization, residential

01/01/2004

91155445

T2023

HE

18

MH-TCM, adult, face-to-face

01/01/2004

91155446

S9484

11

Crisis assessment, intervention and stabilization, non-residential, ind. by professional

01/01/2004

91155447

H0035

08

Partial hospitalization

01/01/2004

91155448

S5165

12

Environmental accessibility adaptations, home modifications/install and expenses

11/01/2004

91155449

T2028

U1

09

CDCS - Personal assistance

10/01/2004

91155450

T2040

16

CDCS - Background check

10/01/2004

91155451

T2041

16

CDCS - Mandatory case management

10/01/2004

91155452

S5100

16

Adult day service (15 minutes)

11/01/2004

91155453

S5102

08

Adult day service (day)

11/01/2004

91155454

S5110

16

Family training

11/01/2004

91155455

S5116

27

Caregiver training/education

11/01/2004

06/30/2013

91155456

S5120

16

Chore services

11/01/2004

91155457

S5125

16

DD, in home family support (15 minutes)

11/01/2004

91155458

S5126

08

Caregiver living expenses

11/01/2004

91155459

S5130

16

Homemaker service - cleaning only (15 minutes)

11/01/2004

91155460

S5131

08

Homemaker services (day)

11/01/2004

91155461

S5140

08

Foster care, adult (day)

11/01/2004

91155462

S5141

18

Foster care, adult (month)

11/01/2004

12/31/2013

91155463

S5145

08

Foster care, therapeutic, child, per diem

11/01/2004

91155464

S5146

18

Foster care, child (month)

11/01/2004

12/31/2013

91155465

S5150

16

Respite care, in home (15 minutes)

11/01/2004

12/31/2013

91155466

S5151

08

Respite care, in home (day)

11/01/2004

91155467

S5170

13

Home delivered meals

11/01/2004

91155469

S9125

08

Crisis respite (day)

11/01/2004

91155470

S9128

UC

29

Extended speech therapy

11/01/2004

91155471

S9129

UC

29

Extended occupational therapy

11/01/2004

91155472

S9131

UC

29

Extended physical therapy

11/01/2004

91155473

S9470

29

Nutritional counseling, diet

11/01/2004

91155474

E1399

12

Durable medical equipment

11/01/2004

05/31/2013

91155475

H0045

08

Respite care services, not in home

11/01/2004

91155476

G0154

16

Direct skilled nursing services - LPN or RN - home

11/01/2004

12/31/2015

91155477

G0156

16

Home health aide/extended home health aide

11/01/2004

06/30/2009

91155479

T1005

16

Crisis respite (15 minutes)

11/01/2004

91155480

T1002

16

RN, regular

11/01/2004

91155481

T1003

16

LPN, regular

11/01/2004

91155482

T1019

UC

16

Extended personal care 1:1

11/01/2004

91155483

T1021

29

Home health aide visit

11/01/2004

91155484

T1020

08

Personal care services

11/01/2004

09/30/2011

91155485

T2038

09

Trans Serv Deposits/Moving Exp

11/01/2004

91155487

S5135

16

Companion care, adult/Personal support

11/01/2004

91155488

S5136

08

Personal support

11/01/2004

12/31/2013

91155490

H0040

08

Assertive Community Treatment (ACT)

07/01/2004

91172029

H2017

HM

UD

16

Transition to Community Living by a mental health rehabilitation worker

01/01/2004

08/31/2016

91172031

H2017

HM

HW

UD

16

Psychosocial rehab., indiv., transitional by rehab worker/state employee

01/01/2004

12/31/2007

91172033

H2017

HM

HW

16

Psychosocial rehab., indiv. by rehab worker/state employee

01/01/2004

12/31/2007

91172035

H2017

HW

UD

16

Psychosocial rehab., indiv., transitional by state employee

01/01/2004

12/31/2007

91172037

H2017

HQ

HW

16

Psychosocial rehab., group by state employee

01/01/2004

12/31/2007

91172045

T2028

U8

09

CDCS - Flexible case management

10/01/2004

91176169

H2017

16

Basic Living and Social Skills - individual; mental health professional or practitioner

01/01/2004

91176171

H2017

HM

16

Basic Living and Social Skills - individual; mental health rehabilitation worker

01/01/2004

91176173

H2017

HW

16

Psychosocial rehab., indiv. by state employee

01/01/2004

12/31/2007

91176175

H2017

HQ

16

Basic Living and Social Skills - group; mental health professional or practitioner, or rehab. worker

01/01/2004

91176177

H2017

UD

16

Transition to Community Living

01/01/2004

08/31/2016

91176200

T2016

U9

08

Supported living services, adult, corporate AFC (day)

10/01/2006

91176280

H2017

HQ

UD

16

Psychosocial rehab., group, transitional

01/01/2004

01/01/2004

91176281

H2017

HM

HQ

UD

16

Psychosocial rehab., group, transitional by rehab worker

01/01/2004

01/01/2004

91176282

H2017

HQ

HW

UD

16

Psychosocial rehab., group, transitional by state employee

01/01/2004

12/31/2007

91176283

H2017

HM

HQ

HW

UD

16

Psychosocial rehab., group, transitional by rehab worker/state employee

01/01/2004

12/31/2007

91176284

H2017

HM

HQ

16

Psychosocial rehab., group by rehab worker

01/01/2004

01/01/2004

91176285

H2017

HM

HQ

HW

16

Psychosocial rehab., group by rehab worker/state employee

01/01/2004

12/31/2007

91176286

90882

27

Environmental or community intervention, mental health professional or practitioner

01/01/2002

91176287

90882

UD

27

Transition to Community Intervention

01/01/2002

08/31/2016

91176288

90882

HM

UD

27

Transition to Community Intervention by a mental health rehabilitation worker

01/01/2002

08/31/2016

91176289

90882

HW

UD

16

Community intervention, indiv., transitional by state employee

01/01/2002

12/31/2007

91176290

90882

HM

HW

UD

16

Community intervention, indiv., transitional by rehab worker/state employee

01/01/2002

12/31/2007

91176291

90882

HM

27

Environmental or community intervention, mental health rehabilitation worker

01/01/2002

91176292

90882

HW

16

Community intervention, indiv. by state employee

01/01/2002

12/31/2007

91176293

90882

HM

HW

16

Community intervention, indiv. by rehab worker/state employee

01/01/2002

12/31/2007

91176294

T2025

09

Consumer Support Grant (CSG)

06/01/2006

91178000

H0025

16

Behaviorial Support, by analyst

10/01/2006

91178001

H0025

TF

16

Behaviorial Support, by specialist

10/01/2006

91178002

H0025

TG

16

Behaviorial Support, by professional

10/01/2006

91178003

H2032

16

Independent living skills, maintenance

10/01/2006

12/31/2013

91178004

H2032

TG

16

Independent living skills, individual therapy

10/01/2006

91178005

H2032

HQ

16

Independent living skills, group therapy

10/01/2006

91178007

T2020

08

DT&H, non-pilot/Structured day program

10/01/2006

91178008

T2020

U5

22

DT&H, non-pilot

10/01/2006

12/31/2013

91178009

T2002

08

DT&H, non-pilot, transportation

10/01/2006

12/31/2013

91178010

T2021

TG

16

DT&H pilot, Rate A

10/01/2006

12/31/2013

91178011

T2021

TF

16

DT&H pilot, Rate B

10/01/2006

12/31/2013

91178012

T2021

UB

16

DT&H pilot, Rate C

10/01/2006

12/31/2013

91178013

T2021

16

DT&H pilot, Rate D/Structured day program

10/01/2006

91178014

T2024

26

DD screening (screen)

10/01/2006

05/31/2007

91178015

T2032

18

Residential care services (month)

10/01/2006

12/31/2013

91178016

T2032

U9

18

Supported living services, adult, corporate AFC (month)

10/01/2006

12/31/2013

91178017

T2032

HA

18

Supported living services, child (month)

10/01/2006

12/31/2013

91178018

T2018

U5

22

Supported employment (partial day)

10/01/2006

12/31/2013

91178019

S0215

UC

14

Transportation, mileage (commercial vehicle)

10/01/2006

12/31/2012

91178020

T2038

TF

32

Housing access coordination

10/01/2006

12/31/2013

91178021

T2029

12

Assistive technology/Supplies and equip., extended

10/01/2006

91178022

T2013

11

Specialist service

10/01/2006

91178023

T2017

HA

16

Supported living services, child (15 minutes)

10/01/2006

91178024

T2016

HA

08

Supported living services, child (day)

10/01/2006

91178025

T2017

16

Supported living services, adult (15 minutes)

10/01/2006

91178026

T2017

U9

16

Supported living services, adult, corporate AFC (15 minutes)

10/01/2006

91178027

T2016

08

Supported living services, adult (day)

10/01/2006

91178028

S5109

27

Consumer training and education

10/01/2006

91178029

T1016

UC

16

Waiver case management

10/01/2006

91178030

S5141

HQ

18

Foster care, adult (month)

10/01/2006

91178031

T2003

UC

28

Non-emergency transportation; encounter/trip (one way)

10/01/2006

91178032

T1019

UA

16

Supervision of PCA

10/01/2006

91178033

T2003

28

Non-emergency transportation; encounter/trip (one way)

10/01/2006

91178034

S5110

TF

16

CAC Family training

10/01/2006

04/30/2009

91178036

T2030

18

Customized living services (monthly)

10/01/2006

12/31/2013

91178037

T2030

TG

18

24-hour customized living (monthly)

10/01/2006

12/31/2013

91178038

T2030

TG

U9

18

24-hour customized living (corporate)

10/01/2006

12/31/2013

91178039

T2019

16

Supported employment (15 minutes)

10/01/2006

91178040

T2018

08

Supported employment (day)

10/01/2006

12/31/2013

91178042

T1016

TF

UC

16

Waiver case management by paraprofessional

10/01/2006

91178043

S5150

UB

16

Respite care, out of home

10/01/2006

91178045

T2015

11

Prevocational services (hour)

10/01/2006

91178046

T2014

08

Prevocational services (day)

10/01/2006

91178047

H2032

TF

16

Independent living skills, counseling

10/01/2006

91178048

T2001

UC

03

Transportation, extra attendant

10/01/2006

91178049

T2031

08

Customized living services (daily)

10/01/2006

91178050

T2033

08

Residential care services (day)

10/01/2006

91238006

T1016

16

AC Conversion

07/01/2001

91238036

T2003

UC

25

Non-emergency transportation; round trip

10/01/2006

09/30/2007

91238039

T2032

34

Supported living services, adult (semi-monthly)

10/01/2006

12/31/2013

91238042

S0215

UC

14

Transportation, mileage

10/01/2006

91238047

T2032

U9

34

Supported living services, adult, corporate AFC (semi-monthly)

10/01/2006

12/31/2013

91238050

T2032

HA

34

Supported living services, child (semi-monthly)

10/01/2006

12/31/2013

91238313

T2032

18

Supported living services, adult (month)

10/01/2006

12/31/2013

91238326

X5527

09

AC Discretionary service

07/01/1999

91238333

H0019

08

Intensive Residential Rehab. Treatment (IRT)

07/01/2004

91238364

T2025

UD

09

Family Support Grant (FSG) with CSG

06/01/2006

07/31/2012

91238374

S5140

U9

08

Foster care, adult, corporate (day)

11/01/2004

91238376

S5141

U9

18

Foster care, adult, corporate (month)

11/01/2004

12/31/2013

91238380

T2038

U1

09

Transitional services, furniture

11/01/2004

91238383

T2038

U2

09

Transitional services, supplies

11/01/2004

91238594

T2024

16

DD Screening (15 minutes)

06/01/2007

91261022

T1030

29

Home health skilled nurse

11/01/2004

91261024

T1030

GT

09

Home health telehomecare

11/01/2004

91299000

H2019

UA

16

Therapeutic behavioral services, Level I MHBA

07/01/2004

91299002

H2019

HM

UA

16

Therapeutic behavioral services, Level II MHBA

07/01/2004

91299004

H2019

HE

UA

16

Therapeutic behavioral services, direction of MHBA

07/01/2004

91308964

S5100

U7

16

Family adult day services (FADS) (15 minutes)

01/01/2008

91308966

S5102

U7

08

Family adult day services (FADS) (day)

01/01/2008

91308974

T1023

16

Life/disability evaluation: Face-to-face LTCC assessment under age 65

04/01/2008

91309042

T1017

16

Relocation Service Coordination (RSC-TCM)

09/01/2008

91413000

T1004

16

Home health aide/extended home health aide

07/01/2009

91413001

S5165

U3

12

Environmental accessibility adaptations, square footage

08/01/2009

91413134

H0001

26

Alcohol and/or drug assessment

07/01/2009

91413136

H0002

26

Behavioral health eligibility screening

07/01/2009

91413239

S9484

HN

11

Crisis assessment, intervention and stabilization, non-residential, ind. by practitioner

01/01/2010

91413243

90882

HK

27

Community intervention, crisis response

01/01/2010

91530002

S5116

TF

32

Caregiver assessment

04/01/2010

06/30/2013

91534000

S5160

12

Emergency response system-installation and testing

05/01/2010

91538000

S5161

12

Emergency response system-service fee, per month

05/01/2010

91538002

S5162

12

Emergency response system-purchase

05/01/2010

91807008

H0040

U6

08

Assertive Community Treatment, MHM

06/01/2013

91807049

H2015

U6

16

Comprehensive community support services, MHM

06/01/2013

91807073

T1016

U6

16

Case management, MHM

06/01/2013

91807099

T2038

U6

09

Transition plan development, MHM

06/01/2013

91807125

T2038

UD

U6

09

Transition coordination, MHM

06/01/2013

12/31/2015

91807151

A0180

U6

09

Non-emergency transportation: ancillary lodging, recipient, MHM

06/01/2013

91807161

A0200

U6

09

Non-emergency transportation: lodging for caseworker, escort, parent, MHM

06/01/2013

91807195

S5135

UA

U6

16

Overnight Assistance, MHM

06/01/2013

91807205

S5160

U6

12

Emergency response system installation and testing, MHM

06/01/2013

91807213

S5161

U6

12

Emergency response system service fee per month, MHM

06/01/2013

91807221

S5162

U6

12

Emergency response system purchase, MHM

06/01/2013

91807229

S5165

U6

12

Environmental accessibility adaptations, MHM

06/01/2013

91807237

S9970

U6

12

Health club membership, annual, MHM

06/01/2013

07/31/2014

91807243

T1028

U6

12

Adaptations - home assessment, MHM

06/01/2013

91807251

T1999

U6

12

Tools, clothing and equipment for employment, MHM

06/01/2013

91807259

T2038

U1

U6

09

Transitional services, furniture, MHM

06/01/2013

91807265

T2038

U2

U6

09

Transitional services, supplies, MHM

06/01/2013

91807271

T2038

UA

U6

09

Transitional services, housing deposit, MHM

06/01/2013

91817000

S5115

16

Caregiver training/education

07/01/2013

91817010

S5115

TF

16

Caregiver Coaching and Counseling/Caregiver Assessment

07/01/2013

91822024

T2011

26

PASRR Level II Screening

09/01/2012

91836004

S5150

16

Respite care, in home (15 minutes)

01/01/2014

91857000

T2029

U6

12

Assistive technology/Supplies and equip., extended, MHM

12/01/2013

12/31/2015

91876000

S9970

U5

U6

18

Health club membership, monthly, MHM

08/01/2014

91904000

H2015

16

Community Living Assistance Services, in person

01/01/2015

91907010

H2016

08

Community Living Assistance Services, remote

01/01/2015

91915000

S5115

TG

16

Family Caregiver Coaching and Counseling/Family Memory Care

07/01/2015

91918000

E1399

NU

12

Durable medical equipment, new

06/01/2013

91918012

E1399

RB

12

Durable medical equipment, repair

06/01/2013

91918020

E1399

RR

12

Durable medical equipment, rental

06/01/2013

91946000

T1017

U6

16

Transition coordination, MHM

01/01/2016

91946030

T2029

U6

NU

12

Durable medical equipment, new, MHM

01/01/2016

91949000

T2029

U6

RB

12

Durable medical equipment, repair, MHM

01/01/2016

91949008

T2029

U6

RR

12

Durable medical equipment, rental, MHM

01/01/2016

91949016

T2029

U6

UE

12

Durable medical equipment, used, MHM

01/01/2016

91949026

E1399

UE

12

Durable medical equipment, used

01/01/2016

91949034

T2029

NU

12

Durable medical equipment, new

01/01/2016

91949042

T2029

RB

12

Durable medical equipment, repair

01/01/2016

91949050

T2029

RR

12

Durable medical equipment, rental

01/01/2016

91949058

T2029

UE

12

Durable medical equipment, used

01/01/2016

91949059

T2039

12

Environmental Accessibility Adaptations / Vehicle Install

12/07/2017

92020000

H2017

U3

16

Basic living and social skills, transitioning to community living (TCL), mental health professional

09/01/2016

92020006

H2017

HM

U3

16

Basic skills, transitioning to community living (TCL) by a mental health rehabilitation worker, less

09/01/2016

92020008

90882

U3

27

Environmental or community intervention; transition to community living (TCL) intervention

09/01/2016

92020010

90882

HM

U3

27

Environmental or community intervention; transition to community living intervention, less than bach

09/01/2016

92045008

S5145

HE

08

Intensive Treatment in Foster Care

01/01/2018

201717525

T2019

U9

16

Employment Exploration

01/01/2022

201717526

T2019

U2

16

Individual Employment Support

01/01/2022

201717529

T2021

UC

08

DT&H pilot, Rate D/Structured day program

01/01/2022

201719527

T2019

HQ

16

Group Employment Support

01/01/2022

201721523

T2024

U8

27

Service assessment/plan of care development, waiver

07/20/2020

201734510

T1016

HX

16

Case management (15 minutes)

10/01/2020

201734518

T2019

U3

16

Employment Development

01/01/2022

201748512

T1016

U8

HN

16

Treatment Coordination

10/01/2020