Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.05-023 - DDS Alternative Community Services (ACS) Update #51
Current through Register Vol. 49, No. 9, September, 2024
272.100 DDS Alternative Community Service (ACS) Waiver Procedure 7-1-05
Codes
The following procedure codes and any associated modifier(s) must be billed for DDS Alternative Community Services (ACS) Waiver Services. Prior authorization is required for all services.
|
Procedure Code |
M1 |
M2 |
PA |
Description |
Unit of Service |
POS for Paper Claims |
POS for Electronic Claims |
|
|
H2016 |
Y |
ACS Supported Living (Individual) |
1 Day |
4, |
0 |
12,99 |
||
|
H2016 |
UB |
Y |
ACS Supported Living (Group) |
1 Day |
4, |
0 |
12,99 |
|
|
H20231 |
Y |
ACS Supported Employment |
15 Minutes |
0 |
99 |
|||
|
T20282 |
Y |
ACS Specialized Medical Supplies |
1 Month |
4, |
0 |
12,99 |
||
|
T2022 |
Y |
ACS Case Management Services |
1 Month |
4, |
0 |
12,99 |
||
|
T20253 |
Y |
ACS Consultation Services |
1 Hour |
4, |
0 |
12,99 |
||
|
T2034 |
Y |
ACS Crisis Center Services |
1 Day |
o, |
4 |
99, 12 |
||
|
T20344 |
U1 |
UA |
Y |
ACS Crisis Intervention Services |
1 Hour |
o, |
4 |
99, 12 |
individuals are limited to a maximum of 32 units (8 hours) of supported employment services per date of service.
A breakdown of the supported employment units of service include:
One unit = 15 minutes to 21 minutes Two units = 22 minutes to 37 minutes Three units = 38 minutes to 52 minutes Four units = 53 minutes to 67 minutes
Reimbursement cannot exceed $300 per month.
individuals may receive twenty-five (25) hours of ACS consultation services per waiver-eligible year.
The following list contains the procedure codes used for ACS physical adaptations. Physical adaptations have a benefit limit of $7500 per year.
|
Procedure Code |
M1 |
M2 |
PA |
Description |
POS for Paper Claims |
POS for Electronic Claims |
|
K0108 |
Y |
Other accessories |
4 |
12 |
||
|
S5160 |
Y |
Emergency response system; installation and testing |
4 |
12 |
|
S5161 |
Y |
Emergency response system; service fee, per month (excludes installation and testing) |
4 |
12 |
|
|
S5162 |
Y |
Emergency response system; purchase only |
4 |
12 |
|
|
S5165 |
U1 |
Y |
Home modifications, per service |
4 |
12 |
Refer to section 272.200 for definitions of the place of service codes listed above.
