CFSS Agency and Budget Model Billing for Worker Training and Development (S5116)
Claims for supervising professionals to train, supervise and evaluate CFSS workers
Community First Services and Supports (CFSS) provider agencies who serve members using the agency model can bill the cost for supervising professionals to train CFSS workers using procedure code S5116. The CFSS agencies should bill their usual and customary charge amount (Minnesota Statutes, 62A.61) to cover the administrative cost for the supervising professional to train, supervise and evaluate the CFSS worker.
The CFSS provider agency pays for the CFSS worker’s time spent in training through their overhead costs. If a CFSS worker is providing personal care while being trained or supervised by the supervising professional, the worker's time can be billed using procedure code T1019.
Claims for supervising professionals supervising and evaluating CFSS services
CFSS provider agencies who serve members using the agency model can bill agency staff time used to:
The total line-item charge is the CFSS agency usual and customary charge amount to cover the administrative cost for the agency staff time used to supervise and evaluate CFSS servies.
Claims for Classes and workshops
Either the CFSS provider agency (agency model) or financial management service (FMS) provider (budget model) can bill for the cost of training classes or workshops. The total line-item charge is the total cost for a class or workshop. A class can take place in a variety of settings and have varying amounts of learners (for example, one-on-one training, traditional classroom course, online class).
CFSS provider agencies cannot bill for the worker’s time spent to attend a training class or workshop from the worker training and development budget. The CFSS provider agency pays for the worker’s time spent attending a training class or workshop through their overhead costs.
FMS providers can bill for the worker’s time spent to attend the training class or workshop. The FMS provider can bill the worker’s time spent to attend a training class or workshop using the T1019 units. Refer to CFSS Agency and Budget Model Billing for CFSS Personal Care Services (T1019).
Agency Model Worker Training and Development
Service Name | HCPCS Procedure Code and Modifier | Authorization Required | Service Unit |
CFSS, Agency, Worker Training and Development | Yes
| 1 unit for the total cost to train, supervise, and evaluate CFSS worker per date of service or total cost for the supervision, and evaluation of CFSS services per date of service 1 unit per class or workshop |
Budget Model Worker Training and Development
Service Name | HCPCS Procedure Code and Modifier | Authorization Required | Service Unit |
CFSS, Budget, Worker Training and Development | CFSS, Budget, Worker Training and Development, Classroom S5116 UB UD | Yes | 1 unit per class or workshop per date of service |
Note: The modifiers UD will not appear on the service agreement letter for agency model members. Providers must refer to the billing chart above to determine if they need to manually add the modifiers on their CFSS claims.
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