Federally approved BI, CAC, CADI, DD and EW waiver plans, Minn. Stat. §256B.85, subd 2(l)

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

Effective Sept. 30, 2026, extended PCA is no longer available. This page applies to CFSS only.

Extended CFSS services: Waiver services that follow Medical Assistance (MA) state plan CFSS policies but are allowed to exceed the state plan limits on amount, duration and frequency based on a person’s assessed need.

The lead agency may only authorize extended CFSS services when all of the following conditions are met:

All policies and limitations on CFSS Manual – PCA/CFSS covered services apply to extended CFSS services, except for the amount and duration of the service.

Extended CFSS services are available on the following waivers:

The person can only use extended CFSS units for personal care services from the CFSS personal care worker.

In the CFSS budget model, extended CFSS units convert into dollars at the same rate as state plan units.

Extended CFSS services are not available on the Alternative Care (AC) program. People on the AC program use state plan CFSS services. For information about the AC program, refer to CBSM – AC.

The person cannot use extended CFSS hours/dollars to purchase goods, services or back-up systems.

All providers who deliver extended CFSS services must meet the same qualifications as providers who deliver state plan services. The following sections provide specific information and links for each provider type.

CFSS provider agencies

The CFSS provider agency must:

For information about provider qualifications, refer to CFSS Manual – PCA/CFSS provider agency requirements overview.

Consultation services providers

The consultation services provider’s qualifications and responsibilities are the same as usual. For more information, refer to CFSS Manual – CFSS consultation services provider requirements.

Financial management services (FMS) providers

The FMS provider’s qualifications and responsibilities are the same as usual. However, the FMS provider must not bill the state for goods or back-up systems using extended waiver funds. For more information, refer to CFSS Manual – FMS provider requirements for CFSS.

The case manager authorizes both state plan and extended CFSS services on the same service agreement using the MnCHOICES Support Plan. The case manager must:

For information about limits and HCPCS procedure codes, refer to Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

Services through a managed care organization (MCO)

BI, CAC, CADI and DD

To authorize extended CFSS services for people on BI, CAC, CADI and DD waivers who are age 65 or older and enrolled in an MCO, the county/Tribal Nation case manager must:

1. Enter placeholder HCPCS procedure code X5609 in MMIS for the state plan CFSS services for which the MCO is responsible for authorizing. When using this code, the case manager must indicate all of the following:

2. Follow the authorization instructions for extended CFSS services outlined above.

EW

To authorize extended CFSS services for people on EW who are enrolled in an MCO, the care coordinator follows the MCO’s procedure, unless the person receives case management through a Tribal Nation. Contact the case manager at the Tribal Nation for more information and also refer to CBSM – Tribal administration and management of HCBS programs.

Extended CFSS hours do not count toward the person’s eligibility for the enhanced rate/budget. However, if the person is eligible for 10 or more hours of state plan CFSS and has a qualifying worker, the enhanced rate/budget also applies to the person’s extended CFSS rate.

For more information, refer to: