Adult Day Support (ADS) and Vocational Habilitation (VH) rules have changed as of 10/15/21.
Here’s what you need to know:
1. You can no longer provide these services in individuals’ homes.
ADS and VH, including on behalf of services, will no longer be allowed in individuals’ homes. Only Homemaker/Personal Care services will be allowable in the home, and must be billed accordingly.
2. You can, however, still provide ADS and VH services virtually.
You will continue to be reimbursed at the C Acuity rate for virtual ADS and VH services delivered through 12/31/21. Virtual services delivered on or after 1/1/22, will be reimbursed at the acuity rate of the individual according to their Acuity Assessment Instrument (AAI).
3. STEP has a new name, and the group size goes back to four (4) on 1/1/22.
The STEP service delivery method is being renamed ADS-Community and VH-Community. This will be a seamless transition that continues to allow services to be provided in small groups in the community.* These services will continue to be reimbursed at the C Acuity, and the maximum group size will stay at five (5) through 12/31/21. For services delivered on or after 1/1/22, the maximum group size will be restored to four (4).
*These services should only be provided at a facility-based site when a drop-in is needed. You may drop into a congregate setting for the amount of time necessary to address individual needs, but your group must remain separate from the individuals receiving traditional facility-based services in the setting.
4. The Community Integration (CI) add-on is going away.
There will no longer be a CI add-on rate due to the changes in #3 above.
MBS can answer any questions you have about these changes.
We can also help you find more revenue through our Billing Process Evaluation. Contact us at 513.201.7474, firstname.lastname@example.org or https://www.medicaidbillingsolutions.com/