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Pennsylvania Code (Last Updated: April 5, 2016) |
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Title 55. PUBLIC WELFARE |
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PART I. Department of Human Services |
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Subpart E. Home and Community-based Services |
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Chapter 51. Office of Developmental Programs Home and Community-based Services |
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SubChapter C. PAYMENTS FOR SERVICES …51.41 |
Section 51.53. Fee schedule rate reimbursement
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(a) A provider of a fee schedule service shall keep fiscal records as required under § 51.46 (relating to audit requirements).
(b) The following fee schedule services apply to HCBS in the Consolidated and P/FDS Waiver, providers of targeted services management and when a provider provides an HCBS to both waiver and base-funded participants in a waiver HCBS location for the following periods:
(1) For the period July 1, 2011, through November 14, 2011:
(i) Nursing.
(ii) Physical therapy.
(iii) Occupational therapy.
(iv) Speech and language therapy.
(v) Behavior therapy.
(vi) Visual/mobility therapy.
(vii) Companion.
(viii) Supplemental habilitation.
(ix) Additional individualized staffing.
(x) Older adult day habilitation.
(xi) Behavior support.
(xii) Supports broker.
(xiii) Home finding.
(xiv) Homemaker/chore.
(2) For the period beginning November 15, 2011:
(i) Nursing.
(ii) Physical therapy.
(iii) Occupational therapy.
(iv) Speech and language therapy.
(v) Behavior therapy.
(vi) Visual/mobility therapy.
(vii) Companion.
(viii) Supplemental habilitation.
(ix) Additional individualized staffing.
(x) Older adult day habilitation.
(xi) Behavior support.
(xii) Supports broker.
(xiii) Home finding.
(xiv) Homemaker/chore.
(xv) Supports coordination.
(c) AWC/FMS HCBS billed on a fee schedule in accordance with the approved applicable waiver, including approved waiver amendments, must include the following HCBS:
(1) Companion.
(2) Home and community habilitation (unlicensed).
(3) Supports broker.
(4) Supported employment.
(5) Unlicensed respite with the exclusion of respite camp.
(6) Homemaker/chore.
(d) Changes in the list of HCBS under the MA Program fee schedule will be published as a notice in the Pennsylvania Bulletin.
(e) HCBS provided through the Adult Autism Waiver are a fee schedule HCBS in accordance with the approved Adult Autism Waiver.
(f) Subsections (b) and (c) do not apply to a provider of HCBS in the Adult Autism Waiver.
Notation
This section cited in 55 Pa. Code § 51.43 (relating to Department rates and HCBS classification); and 55 Pa. Code § 51.51 (relating to fee schedule applicability).