PAWS Roll-Up Codes can affect both your revenue and compliance. These codes group multiple service types under one umbrella, but it’s essential to understand how they are processed.
What You Need to Know
The Ohio Department of Developmental Disabilities (DODD) uses the total authorized units and costs from the Payment Authorization for Waiver Services (PAWS) to determine whether a claim will proceed through the adjudication process to the Ohio Department of Medicaid (ODM) for reimbursement approval.
Common PAWS Roll-Up Codes:
Adult Day Services (A25/F25/S25) – Includes the following service codes:
- Adult Day Support
- Vocational Habilitation
- Adult Day Support – Community
- Voc Hab – Community
- Group Employment Support
Non-medical Transportation (NMT) (A35/F35/S35) – Includes two service codes:
- NMT per trip
- NMT per mile
Important Action Steps
If the individuals you serve have any of these services listed in their Individual Service Plans (ISPs), make sure to review their Cost Projection Tools regularly. Track the units and dollars associated with these services to avoid over-utilization or non-compliance.
You can also use the PAWS Utilization Report in DODD’s Data Warehouse to monitor the units and costs for each service code within the PAWS Roll-Up Codes. This will help you stay on track and compliant.
For details, see Frequently Asked Questions, or reach out to us!
If you have questions, please Email Our Service Team.
