DODD Billing Codes
[Pages:1]Program
I.O. Waiver I.O. Waiver I.O. Waiver I.O. Waiver I.O. Waiver I.O. Waiver I.O. Waiver I.O. Waiver
DODD Billing Codes
Service Title
HPC HPC with Longevity Add-on*** HPC Transportation HPC On site/On call Shared Living HPC Overtime ^Limits! HPC On site/On call Overtime HPC Overtime Emergency
Billing Service Code
APC AQC ATN AOC ASP APV AOV EPV
Service Units
15 Minute 15 Minute Mile 15 Minute Day 15 Minute 15 Minute 15 Minute
Max Pay
$4.32 $4.71 $0.45 $2.20 Per DDP $5.71 $3.30 $5.71
L1 Waiver L1 Waiver L1 Waiver L1 Waiver L1 Waiver L1 Waiver L1 Waiver L1 Waiver L1 Waiver
HPC HPC with Longevity Add-on*** HPC Emergency Care HPC Transportation HPC On site/On call HPC Overtime ^Limits! HPC Overtime Emergency HPC On site/On call Overtime HPC On site/On call Emergency
FPC 15 Minute FQC 15 Minute EPC 15 Minute FTN Mile FOC 15 Minute FPV 15 Minute EPC 15 Minute FOV 15 Minute EOC 15 Minute
$4.32 $4.71 $4.32 $0.45 $2.20 $5.71 $5.71 $3.30 $2.20
SELF Waiver SELF Waiver SELF Waiver
Community Inclusion Personal Assistance
Community Inclusion Transportation
Community Inclusion Personal Assistance Overtime
SAN 15 Minute STI Item (Mile) SPV 15 Minute
$3.08 $0.45 $4.62
* All codes require authorization on the ISP ** Overtime billing has specific instructions, must be billed from the day that you hit 40 hours
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