When a provider of Adult Day Services may use the daily billing unit:
- If the provider delivers between five and seven hours of adult day services in-person to the same individual during one calendar day.
- If the individual does not qualify for, or the provider chooses not to receive, the behavioral support or medical assistance rate modification.
- If the provider does not provide adult day support to the individual in multiple modes on the same day. For example, if the individual receives adult day support in an integrated community setting as part of a group of four or fewer individuals, and in another setting, the provider cannot use the daily billing unit.
These conditions ensure that the use of the daily billing unit is appropriate and compliant with the regulations governing adult day services.
If you have questions, please Email Our Service Team.
