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Administrative Letter 23-02

October 5, 2022

Administrative Letter 23-02

 

Dear Providers,

Developmental Disabilities Services received approval from the Centers for Medicare and Medicaid (CMS) for a historic rate increaseThese increases are effective October 1, 2022.

During the 2022 Oklahoma legislative session, lawmakers funded a 25% increase to the reimbursement rate as part of an effort to ensure all individuals on the waitlist for services are able to receive high-quality care and necessary supports to live in their communities..

For providers and agencies with waiver authorizations from the Oklahoma Healthcare Authority, there is no action required. Rate tables have been updated to reflect the new rates, and there is no need to split or re-submit claims. For state funded services, providers will need to update their invoices to reflect the new rates effective October 1, 2022.

Additionally, the annual financial limit for the In-Home Supports Waivers have also increased, effective October 1. The new annual limit for the In-Home Supports Waiver for Children is $19,283 while the new annual limit for the In-Home Supports Waiver for Adults has risen to $28,914.

The new rates are described and outlined below. This is an updated list correcting the original Oct. 3 rate chart and adding in a chart for state rates.

 

Description Previous Annual Limit  New Annual Limit
In-Home Supports Waivers - Adult $23,131 $28,914
In-Home Supports Waivers - Children $15,426 $19,283

 

Description  Code Service Unit  Current Rate   New Rate 
Adult Day Services S5100 15 Minutes $2.08 $2.60
Agency Companion – Close S5126 U1 Day $100.36 $125.45
Agency Companion - Close Therapeutic Leave S5126 U1 TV Day $100.36 $125.45
Agency Companion – Enhanced S5126 Day $130.52 $163.15
Agency Companion - Enhanced - Therapeutic Leave S5126 TV Day $130.52 $163.15
Agency Companion – Pervasive S5126 TF Day $142.74 $178.43
Agency Companion - Pervasive - Therapeutic Leave S5126 TF TV Day $142.74 $178.43
Center-Based Pre-Vocational Svc - waiver funded T2015 U1 Hour $5.20 $6.50
Center-Based Pre-Vocational Svc - waiver funded – Telehealth T2015 U1 GT Hour $5.20 $6.50
Center-Based Pre-Vocational Svc & TL - state funded T2015 U1 SE Hour $5.20 $6.50
Community-Based Pre-Voc Svc - waiver funded T2015 TF Hour $10.40 $13.00
Community-Based Pre-Voc Svc & TL - state funded T2015 TF SE Hour $10.40 $13.00
Daily Living Supports T2033 Day $160.16 $200.20
Daily Living Supports-Telehealth T2033 GT Day $160.16 $200.20
DLS - Therapeutic Leave T2033 TV Day $160.16 $200.20
Employment Specialist T2019 15 Minutes $6.28 $7.85
Employment Specialist – Telehealth T2019 GT 15 Minutes $6.28 $7.85
Enhanced Community-Based Pre-Voc Svc - waiver funded T2015 Hour $13.85 $17.31
Enhanced Community-Based Pre-Voc Svc & TL - state funded T2015 SE Hour $13.85 $17.31
Enhanced Job Coaching GROUPS of 2-3 T2019 TG HQ 15 Minutes $4.32 $5.40
Enhanced Job Coaching Service (Groups of 4-5) T2019 TG 15 Minutes $4.04 $5.05
Extended Duty Nursing  T1000 15 Minutes $6.76 $10.00
Family Counseling - Group - Psychotherapy 90853 U1 15 Minutes $5.75 $7.19
Family Counseling - Group - Psychotherapy-Telehealth 90853 U1 GT 15 Minutes $5.75 $7.19
Family Counseling - Individual (without Client) 90846 15 Minutes $17.24 $21.55
Family Counseling - Individual (without Client)-Telehealth 90846 GT 15 Minutes $17.24 $21.55
Family Counseling - Individual with Consumer present 90847 15 Minutes $17.24 $21.55
Family Counseling - Individual with Consumer present-Telehealth 90847 GT 15 Minutes $17.24 $21.55
Group Home 10 Bed T1020 Day $47.58 $59.48
Group Home 11 Bed T1020 Day $44.46 $55.58
Group Home 12 Bed T1020 Day $41.86 $52.33
Group Home 6 Bed T1020 Day $75.40 $94.25
Group Home 7 Bed T1020 Day $64.48 $80.60
Group Home 8 Bed T1020 Day $56.42 $70.53
Group Home 9 Bed T1020 Day $51.48 $64.35
Group Home Alternative Living Home 4 Bed T1020 Day $303.68 $379.60
Group Home Community Living 10 bed T1020 Day $125.58 $156.98
Group Home Community Living 11 bed T1020 Day $114.14 $142.68
Group Home Community Living 12 bed T1020 Day $112.84 $141.05
Group Home Community Living 6 Bed T1020 Day $173.42 $216.78
Group Home Community Living 7 bed T1020 Day $148.72 $185.90
Group Home Community Living 8 bed T1020 Day $143.78 $179.73
Group Home Community Living 9 bed T1020 Day $127.66 $159.58
Homemaker S5130 15 Minutes $4.00 $5.00
Homemaker-Respite S5150 15 Minutes $4.00 $5.00
Homemaker-Respite-EVV S5150 32 15 Minutes $4.00 $5.00
Homemaker-State Fund S5130 SE 15 Minutes $4.00 $5.00
HTS - Habilitation Training Specialist T2017 15 Minutes $4.21 $5.26
HTS - Habilitation Training Specialist - EVV T2017 32 15 Minutes $4.21 $5.26
HTS - Habilitation Training Specialist - state funded T2017 SE 15 Minutes $4.21 $5.26
HTS - Habilitation Training Specialist-Telehealth T2017 GT 15 Minutes $4.21 $5.26
HTS - No Supervising Agency - Independent T2017 U1 15 Minutes $1.90 $2.38
Individual Placement in Community-Based, Pre-Vocational T2015 U4 Hour $16.84 $21.05
Individual Placement in Community-Based, Pre-Vocational - Telehealth T2015 U4 GT Hour $16.84 $21.05
Individual Placement in Community-Based, Pre-Vocational, state funded T2015 U4 SE Hour $16.84 $21.05
Individual Placement in Job Coaching, Supported Employment T2019 U4 15 Minutes $6.25 $7.81
Individual Placement in Job Coaching, Supported Employment - Telehealth T2019 U4 GT 15 Minutes $6.25 $7.81
Individual Placement in Job Coaching, Supported Employment, state funded T2019 U4 SE 15 Minutes $6.25 $7.81
Intensive Personal Supports T2017 TF 15 Minutes $4.21 $5.26
Intensive Personal Supports - state funded T2017 TF SE 15 Minutes $4.21 $5.26
Job Coaching (Groups of 4-5) T2019 TF 15 Minutes $3.47 $4.34
Job Coaching GROUPS of 2-3 T2019 HQ 15 Minutes $3.75 $4.69
Job Stabilization/Extended Svc T2019 U1 15 Minutes $1.44 $1.80
Job Stabilization/Extended Svc - Telehealth T2019 U1 GT 15 Minutes $1.44 $1.80
Nursing - Intermittent Skilled Care T1001 Visit $52.52 $65.65
Occupational Therapy G0152 15 Minutes $20.80 $26.00
Occupational Therapy-Telehealth G0152 GT 15 Minutes $20.80 $26.00
Physical Therapy G0151 15 Minutes $20.80 $26.00
Physical Therapy-Telehealth G0151 GT 15 Minutes $20.80 $26.00
Pre-Voc  HTS - Supplemental Supports & TL - state funded T2015 TG SE Hour $13.10 $16.38
Pre-Voc HTS - Supplemental Supports - waiver funded T2015 TG Hour $13.10 $16.38
Psychological - Cognitive/Behavior Treatment - Group 90853 15 Minutes $10.78 $13.48
Psychological - Cognitive/Behavior Treatment - Group - Telehealth 90853 GT 15 Minutes $10.78 $13.48
Psychological Services - Therapy H0004 15 Minutes $21.56 $26.95
Psychological Services - Therapy - Telehealth H0004 GT 15 Minutes $21.56 $26.95
PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY MEMBER 90832 30 Minutes $52.00 $65.00
Remote Supports With Unpaid Staff T2017 U4 15 Minutes $1.45 $1.81
Remotes Supports With Paid Staff T2017 U4 15 Minutes $2.62 $3.28
Respite - Close - S5151 Day $40.00 $50.00
Respite - Intermittent - S5151 Day $19.00 $23.75
Respite - Maximum S5151 Day $79.04 $98.80
Respite in Agency Companion - Contractor - Close S5151 Day $123.24 $154.05
Respite in Agency Companion - Contractor - Pervasive S5151 Day $165.62 $207.03
Respite in Agency Companion - Contractor- Enhanced S5151 Day $153.40 $191.75
Respite in Agency Companion - Contractor- Enhanced - STATE FUNDED S5151 SE Day $153.40 $191.75
Respite in Community Living Group Home - 6 bed setting S5151 Day $196.30 $245.38
Respite in Community Living Group Home - 7 bed setting S5151 Day $171.60 $214.50
Respite in Community Living Group Home - 8 bed setting S5151 Day $166.66 $208.33
Respite in Community Living Group Home - 9 bed setting S5151 Day $150.54 $188.18
Respite in Community Living Group Home 10 bed setting S5151 Day $148.46 $185.58
Respite in Community Living Group Home 11 bed setting S5151 Day $137.02 $171.28
Respite in Community Living Group Home 12 bed setting S5151 Day $135.72 $169.65
Respite in Group Home - 10 bed setting S5151 Day $70.46 $88.08
Respite in Group Home - 11 bed setting S5151 Day $67.34 $84.18
Respite in Group Home - 12 bed setting S5151 Day $64.74 $80.93
Respite in Group Home - 6 bed setting S5151 Day $98.70 $123.38
Respite in Group Home - 7 bed setting S5151 Day $87.36 $109.20
Respite in Group Home - 8 bed setting S5151 Day $79.30 $99.13
Respite in Group Home - 9 bed setting S5151 Day $74.36 $92.95
Respite, In Own Home - Close S9125 TF Day $28.50 $35.63
Respite, In Own Home - Intermittent S9125 U1 Day $19.00 $23.75
Respite, In Own Home - Maximum S9125 Day $57.04 $71.30
Self Directed HTS T2017 U1 TF 15 Minutes $4.21 $5.26
Self-Directed Individual Placement in Job Coaching, Supported Employment T2019 U4 TF 15 Minutes $6.25 $7.81
Skilled Nursing - Licensed Practical Nurse G0300 15 Minutes $14.56 $18.20
Skilled Nursing - Licensed Practical Nurse-Telehealth G0300 GT 15 Minutes $14.56 $18.20
Skilled Nursing - Registered Nurse G0299 15 Minutes $15.60 $19.50
Skilled Nursing - Registered Nurse-Telehealth G0299 GT 15 Minutes $15.60 $19.50
Specialized Family Care Adult - Close S5140 U1 Day $30.00 $37.50
Specialized Family Care Adult - Maximum S5140 Day $56.16 $70.20
Specialized Family Care Child - Close S5145 U1 Day $30.00 $37.50
Specialized Family Care Child - Maximum S5145 Day $56.16 $70.20
Speech/Language Services G0153 15 Minutes $19.54 $24.43
Speech/Language Services-Telehealth G0153 GT 15 Minutes $19.54 $24.43
Transportation - Adapted A0130 Mile $1.35 $1.69
Transportation - Non-Adapted S0215 Mile $0.52 $0.625
Value-Based Incentive Quality Payment T2025 UK Each $500.00 $625.00
Vehicle Modification Assessment T2024 Each $20.80 $26.00

 

State Funded Service Contracts
Rates are listed below:

Description Service Unit Current Rate   New Rate 
Assisted Living Per Day $19.25 $24.06
Individual placement (CIE)   $26.50 $33.13
Follow-Along (CIE)   $26.50 $33.13
Group placement (CIE)   $26.50 $33.13
Assessment (CIE)   $26.50 $33.13
Job Development (CIE)   $26.50 $33.13
Individual placement (CIE) 370 hours $9,805.00 $12,258.10
Follow-Along (CIE) 315 hours $8,347.50 $10,435.95
Group placement (CIE) 292 hours $7,738.00 $9,673.96
Assessment (CIE) 20 hours $530.00 $662.60
Job Development (CIE) 40 hours $1,060.00 $1,325.20
GROUP HOME, 6 BED 1 day $75.40 $94.25
GROUP HOME, 7 BED 1 day $64.48 $80.60
GROUP HOME, 8 BED 1 day $56.42 $70.53
GROUP HOME, 9 BED 1 day $51.48 $64.35
GROUP HOME, 10 BED 1 day $47.58 $59.48
GROUP HOME, 11 BED 1 day $44.46 $55.58
GROUP HOME, 12 BED 1 day $41.86 $52.33
Prader Willi Per day $43.95 $54.94
Sheltered Workshop Per 5-hour day $24.22 $30.28


 

A copy of this letter is posted on the Developmental Disabilities Services page in the Provider Information portion of the DHS website.

If you have questions or concerns, please send an email to TellDDS@okdhs.org.

Sincerely,

Beth Scrutchins, Director

Developmental Disabilities Services
Department of Human Services

 

Last Modified on Oct 07, 2022
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