Billing Guidance By Service Type

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 III. Waiver Services - 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 Bed hold Days using the following bed hold 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 bed hold limitations.
Additional Guidance	See the Community Reporting System (ROCS) for guidance on bed hold 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 Bed hold Days using the following bed hold 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 III. Waiver Services - Residential Habilitation Services
Additional Guidance	See the Community Reporting System (ROCS) for guidance on bed hold 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 Bed hold Days using the following bed hold 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 III. Waiver Services - Residential Habilitation Services
Additional Guidance	See the Community Reporting System (ROCS) for guidance on bed hold 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 Bed hold Days using the following bed hold 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 III. Waiver Services - Residential Habilitation Services
Additional Guidance	See the Community Reporting System (ROCS) for guidance on bed hold 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 III. Waiver Services - 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 III. Waiver Services - 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 III. Waiver Services - 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 and/or annual cost limit/individual budget Adult Waiver: State fiscal year maximum of 104 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 III. Waiver Services - 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 III. Waiver Services - 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 III. Waiver Services - 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 III. Waiver Services - 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 III. Waiver Services - 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 III. Waiver Services - 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 III. Waiver Services - 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 III. Waiver Services - 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 VIII. Service Authorization and Prior Approval for more information
Additional Guidance	See under III. Waiver Services - 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 VIII. Service Authorization and Prior Approval for more information
Additional Guidance	See under III. Waiver Services - 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. Summary of Specific Provider Qualifications and Credentials

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. Summary of Specific Provider Qualifications and Credentials

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 monthly 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 Department 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 III. Waiver Services - 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 service for sessions attending. Must provide documentation of attendance at event.
Non-Billable Time	Sessions not attended by the unpaid care giver.
Additional Guidance	Please see under III. Waiver Services - Self-Directed Services for more information