Individual Service and Support Advocacy

Program Code 50D
Max Allowed 25 hours per fiscal year, unless a written extension request is submitted and approved
Units Hours and minutes rounded to the nearest 15 minutes
Billable Time
  • Participating in service plan development and monitoring
  • Visiting individuals, including travel time
  • Completing and filing required documents, such as the annual redetermination of Waiver Eligibility and visiting notes
  • Telephone calls on behalf of the individual
See the ISSA Guidelines for more specific information
Non-Billable Time
  • Time spent assessing or determining initial eligibility of an individual for waiver services
  • Required follow-up visits during the first 30 days after service initiation
  • Time spent providing a service to an individual or family after the individual is no longer receiving the direct waiver service
  • QMRP training time or other general activities that are not for the direct benefit of the waiver participant
  • Time spent entering billing in ROCS
Additional Guidance Please see ISSA 

Residential Services

CILA:  Individual Rate Model (may be 24-hour, host family, intermittent or family)

Program Code 60D
Max Allowed 365 days per fiscal year (366 in leap year)
Units Per Diem
Billable Time
  • Bill daily for every date the individual is present and receiving services in the residential site for at least part of the date (the date is considered to be from midnight to midnight). Use the code: P - present
  • Bill daily for intermittent and family CILA services, this also includes dates when only on-call availability of services was provided. Use the code: P - present
  • Bill Bedhold Days using the following bedhold codes:
    • F - vacation or family/home visits
    • H - hospitalization
    • C - convalescent care
    • S - State-operated facility stays
    • I - incarceration
Non-Billable Time Please see 59 Ill. Adm. Code 115.215c  and the CILA Rate User Guide for additional guidance on CILA bedhold limitations.
Additional Guidance See the ROCS Manual for guidance on bedhold coding.

CILA:  Non-Rate Model

Program Code 61D
Max Allowed 365 days per fiscal year (366 in leap year)
Units Per Diem
Billable Time Bill daily for every date the individual is present and receiving services in the residential site for at least part of the date (the date is considered to be from midnight to midnight). Use the code: P - present
  • Bill daily for intermittent and family CILA services, this also includes dates when only on-call availability of services was provided. Use the code: P - present
  • Bill Bedhold Days using the following bedhold codes:
  • F - vacation or family/home visits
  • H - hospitalization
  • C - convalescent care
  • S - State-operated facility stays
  • I - incarceration
Non-Billable Time More information under Residential Habilitation Services
Additional Guidance See the ROCS Manual for guidance on bedhold coding.

Community Living Facility (CLF) 

Program Code 67D
Max Allowed 365 days per fiscal year (366 in leap year)
Units Per Diem
Billable Time Bill daily for every date the individual is present and receiving services in the residential site for at least part of the date (the date is considered to be from midnight to midnight). Use the code: P - present
  • Bill daily for intermittent and family CILA services, this also includes dates when only on-call availability of services was provided. Use the code: P - present
  • Bill Bedhold Days using the following bedhold codes:
  • F - vacation or family/home visits
  • H - hospitalization
  • C - convalescent care
  • S - State-operated facility stays
  • I - incarceration
Non-Billable Time More information under Residential Habilitation Services
Additional Guidance See the ROCS Manual for guidance on bedhold coding.

Child Group Home

Program Code 17D
Max Allowed 365 days per fiscal year (366 in leap year)
Units Per Diem
Billable Time Bill daily for every date the individual is present and receiving services in the residential site for at least part of the date (the date is considered to be from midnight to midnight). Use the code: P - present
  • Bill daily for intermittent and family CILA services, this also includes dates when only on-call availability of services was provided. Use the code: P - present
  • Bill Bedhold Days using the following bedhold codes:
  • F - vacation or family/home visits
  • H - hospitalization
  • C - convalescent care
  • S - State-operated facility stays
  • I - incarceration
Non-Billable Time More information under Residential Habilitation Services
Additional Guidance See the ROCS Manual for guidance on bedhold coding.

Hourly Intermittent CILA

Program Code 65H
Max Allowed Agency funding maximum per fiscal year, no individual unit maximum.
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time Actual one-on-one staff hours of direct service
Non-Billable Time More information under Residential Habilitation Services

Temporary Intensive Staffing

Program Code 53R - Residential Setting
53D - DT Setting
Max Allowed Temporary, one-to-one staffing, usually in 240-hour increments.
Units Hour and minutes rounded to the nearest 15 minutes.
Billable Time Actual one-on-one staff hours of direct service 
Non-Billable Time More information under Residential Habilitation Services

Day Programs

All Day Programs

For participants in Home-Based Support Services, day programs are included in the participant's monthly cost limit/individual budget.

Developmental Training

Program Code 31A and 31U
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes.
Billable Time The payment rates include transportation costs.
  • The State designed day program rates to include an absentee factor to pay for a full State Fiscal Year of participation in the first 1,100 hours of billing. An individual may be absent 20 of the expected 240 days without reduction in annual payment amount.
  • Only hours when the individual is participating actively in day program activities are billable.
Non-Billable Time Examples of time that are not billable include:
  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.
Additional Guidance More information under Day Habilitation and Other Day Program Services 

Supported Employment - Job Coach - Individual

Program Code 39U
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes
Billable Time Hours billed may not also be billed to the Division of Rehabilitation Services Vocational Rehabilitation Program.
  • Paid supported employment bills will automatically be counted toward the Grant-in Aid Program (390 Program Code) for variance purposes. Billing these fee-for-service program codes and also service reports to program 390 for the same service time is not necessary.
  • When Supported Employment services are provided at a work site where persons without disabilities are employed, payment is made only for the adaptations, supervision and training required by participants receiving waiver services as a result of their disabilities.
Non-Billable Time

Does not include payment for the supervisory activities rendered as a normal part of the business setting.

Examples of time that are not billable include:

  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.

Supported Employment - No Job Coach - Individual

Program Code 36U
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes
Billable Time Hours billed may not also be billed to the Division of Rehabilitation Services Vocational Rehabilitation Program.
  • Paid supported employment bills will automatically be counted toward the Grant-in Aid Program (390 Program Code) for variance purposes. Billing these fee-for-service program codes and also service reports to program 390 for the same service time is not necessary.
  • When Supported Employment services are provided at a work site where persons without disabilities are employed, payment is made only for the adaptations, supervision and training required by participants receiving waiver services as a result of their disabilities.
Non-Billable Time Does not include payment for the supervisory activities rendered as a normal part of the business setting.
Examples of time that are not billable include:
  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.

Supported Employment - Job Coach - Group

Program Code 39G
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes
Billable Time Hours billed may not also be billed to the Division of Rehabilitation Services Vocational Rehabilitation Program.
  • Paid supported employment bills will automatically be counted toward the Grant-in Aid Program (390 Program Code) for variance purposes. Billing these fee-for-service program codes and also service reports to program 390 for the same service time is not necessary.
  • When Supported Employment services are provided at a work site where persons without disabilities are employed, payment is made only for the adaptations, supervision and training required by participants receiving waiver services as a result of their disabilities. 
Non-Billable Time Does not include payment for the supervisory activities rendered as a normal part of the business setting.
Examples of time that are not billable include:
  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.

Supported Employment - No Job Coach - Group

Program Code 36G
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes
Billable Time Hours billed may not also be billed to the Division of Rehabilitation Services Vocational Rehabilitation Program.
  • Paid supported employment bills will automatically be counted toward the Grant-in Aid Program (390 Program Code) for variance purposes. Billing these fee-for-service program codes and also service reports to program 390 for the same service time is not necessary.
  • When Supported Employment services are provided at a work site where persons without disabilities are employed, payment is made only for the adaptations, supervision and training required by participants receiving waiver services as a result of their disabilities. 
Non-Billable Time Does not include payment for the supervisory activities rendered as a normal part of the business setting.
Examples of time that are not billable include:
  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.

Adult Day Care

Program Code 35U
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes
Billable Time The payment rates include transportation costs.
  • The State designed day program rates to include an absentee factor to pay for a full State Fiscal Year of participation in the first 1,100 hours of billing. An individual may be absent 20 of the expected 240 days without reduction in annual payment amount.
  • Only hours when the individual is participating actively in day program activities are billable.
Non-Billable Time

Hours billed may not also be billed to the Department of Aging or the Division of Rehabilitation Services Home Services Program.

Examples of time that are not billable include:

  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.

At Home Day Program

Program Code 37U
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes
Billable Time The payment rates include transportation costs.
  • The State designed day program rates to include an absentee factor to pay for a full State Fiscal Year of participation in the first 1,100 hours of billing. An individual may be absent 20 of the expected 240 days without reduction in annual payment amount.
  • Only hours when the individual is participating actively in day program activities are billable.
Non-Billable Time

Hours billed may not also be billed to the Department of Aging or the Division of Rehabilitation Services Home Services Program.

Examples of time that are not billable include:

  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.

Regular Work/Sheltered Employment

Program Code 38U
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes
Billable Time Paid Regular Work/Sheltered Employment bills will automatically be counted toward the Grant-in Aid Program (380 Program Code) for variance purposes. Billing this fee-for-service program code and also service report to program 380 for the same service time is not necessary.
Non-Billable Time Examples of time that are not billable include:
  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.

Other Day Program

Program Code 30U
Max Allowed State fiscal year maximum of 1,100 hours for any combination of day programs. Monthly maximum is 115 hours for any combination of day programs.
Units Client hours and minutes of individual participation. Minutes may be rounded to the nearest 15 minutes
Billable Time The payment rates include transportation costs.
  • The State designed day program rates to include an absentee factor to pay for a full State Fiscal Year of participation in the first 1,100 hours of billing. An individual may be absent 20 of the expected 240 days without reduction in annual payment amount.
  • Only hours when the individual is participating actively in day program activities are billable.
Non-Billable Time Examples of time that are not billable include:
  • Holidays and weekends when the program is closed.
  • Time beyond regularly scheduled program hours for special events, such as extended field trips, overnight outings, etc.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the training is being provided.
  • Time between arrival and the start of active programming.
  • Time after the end of active programming while waiting for transportation.
  • Lunchtime, unless the individual's service plan indicates a need for active programming during lunch and the training is being provided.
  • Time spent receiving therapy services. Day program hours may not be billed when an individual is receiving direct professional behavior services or other non-day program services.

Behavior Services General Guidelines

For all behavior services, therapists may bill for services that directly benefit the individual, that are within the statewide maximums and the agreed hours in the HBS Service Agreement, if applicable, and that the therapist delivered and documented.

Behavior service hours may not be billed during day program hours, unless the professional is observing the behaviors in the natural environment while the individual is participating as usual in the day program.

Behavior Intervention and Treatment

Program Code 56U
Max Allowed
  • For HBS, Behavior Intervention and Treatment is included in the participant's monthly cost limit/individual budget
  • Adult Waiver: State fiscal year maximum of 66 hours (including adult HBS).
  • Children's Support Waiver (Children's HBS): No fiscal year service maximum.
  • Children's Residential Waiver: State fiscal year maximum of 66 hours.
Units

Hours and minutes rounded to the nearest 15 minutes. There are two levels:

Level 1: Licensed clinical psychologists and certified behavior analysts

Level 2: All other qualified providers

Billable Time
  • Services that directly benefit the individual, that are within the statewide maximums and the agreed hours in the HBS Service Agreement, if applicable, and that the therapist delivered and documented.
  • Indirect services such as writing recommendations, planning and consultations with school personnel are permitted.
Non-Billable Time
  • No direct services may be delivered under the Waiver during the typical school day relative to the age of the participant or during times when educational services are being provided.
  • Planning for school services and training for school staff may not be included.
  • Behavior service hours may not be billed during day program hours, unless the professional is observing the behaviors in the natural environment while the individual is participating as usual in the day program.
Additional Guidance For more information, please see under Professional Services

Individual Counseling

Program Code 57U
Max Allowed 60 hours per SFY of combined psychotherapy/ counseling
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time Services that directly benefit the individual, are within the statewide maximums and the agreed hours in the HBS Service Agreement, if applicable, and that the therapist delivered and documented.
Non-Billable Time

Time billed may not also be billed to the Division of Mental Health Community Mental Health Medicaid Rehabilitation Option or Clinic Option (MRO/MCO).

Behavior service hours may not be billed during day program hours, unless the professional is observing the behaviors in the natural environment while the individual is participating as usual in the day program.

Additional Guidance For more information, please see under Professional Services

Group Counseling

Program Code 57G
Max Allowed 60 hours per SFY of combined psychotherapy/ counseling
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time Services that directly benefit the individual, are within the statewide maximums and the agreed hours in the HBS Service Agreement, if applicable, and that the therapist delivered and documented.
Non-Billable Time
  • Time billed may not also be billed to the Division of Mental Health Community Mental Health Medicaid Rehabilitation Option or Clinic Option (MRO/MCO).
  • Behavior service hours may not be billed during day program hours, unless the professional is observing the behaviors in the natural environment while the individual is participating as usual in the day program.
Additional Guidance For more information, please see under Professional Services

Individual Psychotherapy

Program Code 58U
Max Allowed 60 hours per SFY of combined psychotherapy/ counseling
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time Services that directly benefit the individual, are within the statewide maximums and the agreed hours in the HBS Service Agreement, if applicable, and that the therapist delivered and documented.
Non-Billable Time
  • Time billed may not also be billed to the Division of Mental Health Community Mental Health Medicaid Rehabilitation Option or Clinic Option (MRO/MCO).
  • Behavior service hours may not be billed during day program hours, unless the professional is observing the behaviors in the natural environment while the individual is participating as usual in the day program.
Additional Guidance For more information, please see under Professional Services

Group Psychotherapy

Program Code 58G
Max Allowed 60 hours per SFY of combined psychotherapy/ counseling
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time Services that directly benefit the individual, are within the statewide maximums and the agreed hours in the HBS Service Agreement, if applicable, and that the therapist delivered and documented.
Non-Billable Time
  • Time billed may not also be billed to the Division of Mental Health Community Mental Health Medicaid Rehabilitation Option or Clinic Option (MRO/MCO).
  • Behavior service hours may not be billed during day program hours, unless the professional is observing the behaviors in the natural environment while the individual is participating as usual in the day program.
Additional Guidance For more information, please see under Professional Services

Physical Therapy, Occupational Therapy, Speech Therapy

Program Code Physical Therapy - 52P
Occupational Therapy - 52O
Speech Therapy - 52S
Max Allowed 26 hours, or 52 hours with justification per state fiscal year for each therapy.
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time
  • The therapist may bill for time spent working directly with the individual or, for occupational and physical therapy, the time a certified/licensed assistant under his or her direct supervision spends working directly with the individual in accordance with the individual service plan. Direct supervision means that the therapist is accessible at all times while the assistant is treating individuals. It also means that the therapist does on-site supervision every four to six sessions to assess progress and revise the treatments as needed.
  • Time spent with the individual demonstrating specific interventions to be used by family, direct support and other workers to ensure they will be done properly and frequently enough to be effective.
  • Participation in development of the individual service plan.
Non-Billable Time
  • Time spent by the therapist supervising assistants.
  • Time spent in general staff training
  • Evaluations, including evaluations for equipment or fittings, may not be billed to the Division of DD. They must be billed to the Department of Healthcare and Family Services Medicaid State Plan instead.
  • Transportation time.
  • Time when the individual is receiving therapy services is not billable as day program services.
  • Time billed to the Department of Healthcare and Family Services for the service.
Additional Guidance More information under Therapies 

Adaptive Equipment, Assistive Technology, Home Accessibility Modifications and Vehicle Accessibility Modifications

Adaptive Equipment

Program Code 53E
Max Allowed
  • For Home-Based Support Services (HBS), this service is not included in the participant's monthly cost limit/individual budget.
  • For all three waivers, a $15,000 maximum per individual per five-year period applies for any combination of adaptive equipment, assistive technology, home modifications and vehicle modifications, as applicable.
Units Event Mode
Billable See Service Authorization and Prior Approval for more information 
Additional Guidance See under Adaptive Equipment, Assistive Technology, Vehicle Modifications and Home Accessibility Modifications for more information. 

Assistive Technology

Program Code 53T
Max Allowed
  • For Home-Based Support Services (HBS), this service is not included in the participant's monthly cost limit/individual budget.
  • For all three waivers, a $15,000 maximum per individual per five-year period applies for any combination of adaptive equipment, assistive technology, home modifications and vehicle modifications, as applicable.
Units Event mode
Billable See Service Authorization and Prior Approval for more information
Additional Guidance See under Adaptive Equipment, Assistive Technology, Vehicle Modifications and Home Accessibility Modifications for more information. 

Home Accessibility Modifications

Program Code 53H
Max Allowed
  • For all three waivers, a $15,000 maximum per individual per five-year period applies for any combination of adaptive equipment, assistive technology, home modifications and vehicle modifications, as applicable.
  • Within the five-year maximum, there is also a $5,000 maximum per address for permanent home modifications for rented homes.
Units Event Mode
Billable Time See Service Authorization and Prior Approval for more information
Additional Guidance See under Adaptive Equipment, Assistive Technology, Vehicle Modifications and Home Accessibility Modifications for more information. 

Vehicle Accessibility Modifications

Program Code 53V
Max Allowed For all three waivers, a $15,000 maximum per individual per five-year period applies for any combination of adaptive equipment, assistive technology, home modifications and vehicle modifications, as applicable.
Units Event Mode
Billable Time See Service Authorization and Prior Approval for more information
Additional Guidance See under Adaptive Equipment, Assistive Technology, Vehicle Modifications and Home Accessibility Modifications for more information. 

Self-Directed Services (Home-Based Support Services and Children's Support Waiver)

Service Facilitation

Program Code 55A
Max Allowed None, subject to the amount specified in the ISP, the HBS Service Agreement and the overall HBS service cost maximum.
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time
  • On-site visits
  • Face-to-face time
  • Service planning & monitoring time
  • Provider recruitment
  • Enrollment & orientation to the program
  • Paperwork & telephone contacts
  • Counseling/Training time with the individual, family or informal supports upon request
  • Travel time (excluding commuting)
  • Advocacy regarding individual's benefits & services (i.e., Medicaid)
Non-Billable Time
  • Commute time (to and from worker's home)
  • QSP training (training is reimbursed separately)
  • General activities (agency reviews not for direct benefit of specific HBS participant, time spent by other agency staff on billing, payroll, etc.)
Additional Guidance HBS Service Agreement form must be in place to document amount of hours of this service included in ISP and agreed to by HBS participant or representative.  Minimum of 2 hrs. per month must be allocated as part of the ISP.

Personal Support

Program Code 55D
Max Allowed None, subject to the amount specified in the ISP, the HBS Service Agreement and the overall HBS service cost maximum.
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time
  • Face-to-face time
  • Time for participation in ISP meeting
  • Time for writing progress notes
  • Time for consulting with HBS Service Facilitator
Non-Billable Time
  • Time when participant is not present
  • Commute time (travel to and from worker's home)
Additional Guidance

The service planning team, lead by the participant and Service Facilitator, negotiates mutually acceptable rates for this service. The HBS Service Facilitator Agreement form specifies authorized hourly rate and maximum monthly units of service.

For Personal Support Workers hired directly by participant or representative (domestic employees), wages earned are considered taxable income.  Payroll is issued by a Fiscal/Employer Agent (F/EA).  Payment authorization is sent by HBS Service Facilitator to F/EA based on the ISP.  Payment may not be made for certain legally responsible relatives for children.  See Section VII for requirements and restrictions on certain relatives.  http://intranet.dhs/onenet/page.aspx?item=52738

Temporary Assistance (formerly Crisis Services)

Program Code 53C
Max Allowed Maximum of $2,000 per month for up to two months (60 consecutive days) for total maximum of $4,000
Units Hours and minutes rounded to the nearest 15 minutes.
Billable Time
  • Face-to-face time
  • Participation in ISP Meeting
  • Writing Progress Notes
  • Time consulting with HBS Service Facilitator about participant
Non-Billable Time
  • Time when participant is not present
  • Travel time (commute to and from worker's home)
Additional Guidance

The service planning team, lead by the participant and Service Facilitator, negotiates mutually acceptable rates for this service. The HBS Service Facilitator Agreement form specifies authorized hourly rate and maximum monthly units of service.

For Personal Support Workers hired directly by participant or representative (domestic employees), wages earned are considered taxable income.  Payroll is issued by a Fiscal/Employer Agent (F/EA).  Payment authorization is sent by HBS Service Facilitator to F/EA based on the ISP.  Payment may not be made for certain legally responsible relatives for children.  See Section VII for requirements and restrictions on certain relatives.  http://intranet.dhs/onenet/page.aspx?item=52738

Nursing

Program Code RN - 55N
LPN - 55P
Max Allowed Combined total of 365 hours of nursing per year
Units Hours and minutes rounded to the nearest 15 minutes
Billable Time
  • Face-to-face with HBS participant
  • Time spent participating in ISP meeting
  • Time spent writing progress notes
  • Time spent consulting with HBS Service Facilitator
Non-Billable Time
  • Time when participant is not present
  • Travel time (commute to and from worker's home)
Additional Guidance The ISP and HSB Service Agreement form specifies the authorized hourly rate and maximum monthy units of service.

Emergency Home Response Services

Program Code

55W

Level 1: Installation

Level 2: Monthly monitoring Charge

Max Allowed Installation charge is limited to one per participant.  Monthly charge is determined by State.  Participants must use a vendor approved by the Illinois Deparment on Aging.
Units

Level 1:  One-time charged billed as Event mode

Level 2: Monthly charge billed as Event mode

Additional Guidance Not a covered service for children.

Transportation (Non-Medical)

Program Code 55T
Max Allowed $500 per month par participant
Units Varies, can bill for mileage, cab fares or bus tokens. Billed as Event mode.
Billable Mileage when participant is present in vehicle
Non-Billable Mileage when participant is NOT present in vehicle
Additional Guidance Not a covered service for children.

Counseling Services for Unpaid Care Givers

Program Code 55C
Max Allowed None - subject to approved ISP and HBS Service Agreement
Units Hours and minutes rounded to the nearest 15 minutes
Billable Time Therapists may bill for all behavioral services that:
  • directly benefit the individual
  • are within statewide maximums (if applicable)
  • within agreed hours in HBS Service Agreement and ISP
  • time therapist delivered counseling service, with documentation to support hours being billed
Non-Billable Time Time that is not for the direct benefit of the individual.
Additional Guidance Please see under Self-Directed Services for more information

Training for Unpaid Care Givers

Program Code 55B
Max Allowed None (subject to approved ISP and HBS Service Agreement
Billable Tuition and fees to attend training events, seminars, etc.  Billed as Event mode servce for sessions attending.  Must provide documentation of attance at event.
Non-Billable Time Sessions not attende by the unpaid care giver.
Additional Guidance Please see under Self-Directed Services for more information