CDSS Rate Reforms for 905, 910, 915, and 920 Service Codes
The new service levels implement new staffing and consultation hour requirements. Consultation hours will be required even for those who are currently not requiring them. The new sub-codes are based on the service levels for residential facilities. It differentiates facilities that serve five or more individuals and those that serve four or fewer. The number of beds and whether the residential facility is owner-operated or staff-operated will be the basis for the rates.
The facilities that participated in the DDS provider directory are given a 10% as the Quality Incentive Payment. The full 100% rate is inclusive of this benefit. The base rate for the other facilities that did not participate in the provider directory has 90% as their full rate. The 10% Quality Incentive Payment can only be received once they participate. Currently, DDS has not yet announced when the provider directory will reopen.
POS authorizations for program support will be tied to a sub-code. Aside from the service code and rate, the new sub-code for the one-to-one support is present. The benchmark rate for those who participated in the provider directory is $31.54 per hour. For those that did not, the base rate is $28.39 per person per hour. The Quality Incentive Payment amount of $3.15 is already included in the full benchmark rate of $31.54.
The service code, 880, for transportation services is for those that provide transportation to an individual to and from their day program. It is only transportation for day activity and does not include transportation during typical residential services that you provide nor going out to the community during weekends or for groceries. Sub-codes are now added in this service code based on an individual being ambulatory or non-ambulatory. They have different rates where non-ambulatory individuals being transported have higher rates. The rate per trip for ambulatory persons is $1484 and a rate of $1553 for those that are non-ambulatory. The Quality Incentive Payment for ambulatory transportation is $1.65 per trip while the non-ambulatory transportation is $1.73.
The service providers shall complete the rate reform service acknowledgment form for each one of the vendor numbers for the program support, transportation services, and residential facilities. The providers are advised to review the directives and workbooks to ensure accuracy and agreement. As for the workbooks, residential facilities are not included. The providers are advised to contact the accounting department in case of errors or discrepancies in the workbooks. Service providers are required to implement the Quality Incentive Payment and rate adjustment.
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If you want to read the recent updates about CDSS, you can read the articles of Ca Care Association on 2024 Chaptered Legislation Affecting Adult and Senior Care Facilities and the 2024 Manual Letter for Dementia Care in Residential Care Facilities for the Elderly (RCFE) and Miscellaneous Regulation Changes, ORD No. 0423-03.
