For participants in Home-Based Support Services, day programs are included in the participant's monthly cost limit/individual budget.
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:
Hours billed may not also be billed to the Department of Aging or the Division of Rehabilitation Services Home Services Program.
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.
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
Time billed may not also be billed to the Division of Mental Health Community Mental Health Medicaid Rehabilitation Option or Clinic Option (MRO/MCO).
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. Summary of Specific Provider Qualifications and Credentials
Level 1: Installation
Level 2: Monthly monitoring Charge
Level 1: One-time charged billed as Event mode
Level 2: Monthly charge billed as Event mode
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