6000, Reimbursement and Billing

Revision 06-0; Effective May 22, 2006

The Department of Aging and Disability Services (DADS) will pay for authorized services provided and billed in compliance with Chapter 62.

DADS will reimburse the Transition Assistance Services (TAS) provider agency a one-time fee and the invoice amount for delivered TAS. The TAS provider agency must submit a claim for reimbursement to DADS after it has contacted the individual to confirm that the authorized TAS services were delivered. A separate claim may be submitted for each authorized and delivered item or service; however, the TAS provider agency is only entitled to one TAS fee per individual.

The following service codes and procedures (bill) codes have been established for TAS:

Description Service Code Procedure Code Qualifier Procedure Code Rate
CBA TAS 53 HC T2038 $1.00
CLASS TAS 53 HC T2038 $1.00
CWP TAS 53 HC T2038 $1.00
DBMD TAS 53 HC T2038 $1.00
MDCP TAS 53 HC T2038 $1.00

The TAS agency must enter the total dollar amount of the TAS purchases in the "number of units" and $1.00 in the "unit rate" field.

Description Service Code Procedure Code Qualifier Procedure Code Unit Rate
CBA TAS Fee 53A ZZ G0239 $156.00
CLASS TAS Fee 53A ZZ G0239 $156.00
CWP TAS Fee 53A ZZ G0239 $156.00
DBMD TAS Fee 53A ZZ G0239 $156.00
MDCP TAS Fee 53A ZZ G0239 $156.00

The TAS agency must enter a "1" in the "number of units" field and the effective TAS fee in the "unit rate" field.