4100, Habilitation Coordination Service Authorization Revision

Revision 19-0; Effective July 7, 2019

The habilitation coordinator must send a request for habilitation coordination service units from HHSC. To be paid for participating in the initial IDT meeting, a request must be sent using designated Form 2358, Habilitation Coordination Authorization Request, and faxed to the HHSC Provider Claims section at 512-438-2301 within three business days of the initial IDT for processing. If the IDT agrees to the provision of habilitation coordination for the individual, the LIDDA requests habilitation coordination for 12 months effective the date of the IDT meeting.

Service authorizations may take five to seven business days to appear on Medicaid Eligibility and Service Authorization Verification (MESAV).

4110 Habilitation Coordination Service Authorization Requests

Revision 19-0; Effective July 7, 2019

There are six habilitation coordination authorization requests that the habilitation coordinator will identify on Form 2358, Habilitation Coordination Authorization Request, that will be processed by HHSC staff:

• Initial — LIDDA requests initial authorization for habilitation coordination for 12 units for one year if the individual accepts a recommendation for habilitation coordination.
• Refusal — LIDDA requests one unit to cover the initial IDT if the individual refuses habilitation coordination.
• Renewal — LIDDA requests renewal of authorization for habilitation coordination (12 service units) for the next year.
• CLO — LIDDA requests one additional unit of habilitation coordination to provide CLO in accordance Section 5810.1 of the IDD PASRR Handbook for an individual who has refused habilitation coordination.
• Revision — LIDDA requests additional units of habilitation coordination. This usually occurs when an individual requests habilitation coordination after an initial refusal.
• Termination —There are two types of termination:
  • Voluntary: When an individual, or LAR on his or her behalf, requests an end to habilitation coordination.
  • Involuntary: The second type is to request an end to an authorization for habilitation coordination for an individual who has transferred to an NF in the service area of another LIDDA.

4120 Termination Codes

Revision 19-0; Effective July 7, 2019

For all terminations submitted by the habilitation coordinator, an accompanying code will need to be used to reflect what type of termination is being submitted. Below are the codes: