Authors Posts by mile6-anthony



The Office of Long-Term Living (OLTL) issued a notice to announce a procedure code change for Cognitive Rehabilitation Therapy (CRT) Services within the OBRA Waiver. Due to 2020 Healthcare Common Procedure Coding System (HCPCS) updates, the procedure code for CRT in the OBRA Waiver is changing from 97127 SE (which was end-dated as of May 25, 2020) to 92507 SE (effective May 26, 2020).

The service definition and units of service will remain the same. OBRA Waiver Cognitive Rehabilitation Providers will be required to utilize “92507 SE” for claims submitted with dates of service 5/26/2020 forward for Cognitive Rehabilitation. The “OLTL Home and Community-Based Waiver Services Rates” sheet has been updated to reflect the change.

Another automated system update is scheduled to occur in HCSIS on 5/29/2020 to add the new “92507 SE” code so it is available for selection onto OBRA Waiver FY 2020-2021 service plans. Service Coordinators (SC) will need to manually add the new service code “92507 SE” onto OBRA Waiver FY 2020-2021 service plans. OLTL’s Participant Services Review Unit within the Division of Fee- For- Service (FFS) Operations will be working directly with impacted OBRA Waiver Service Coordination Entities (SCE) to address any additional FY 2020-2021 service plan updates.

Members that have billing questions regarding this procedure code change or wish to receive the new rates sheet in an alternate format should contact the OLTL Provider Inquiry Unit or 800-932-0939.

ODP Announcement 20-059 provides operational guidance through a Frequently Asked Questions (FAQ) format regarding services rendered through the Consolidated, Community Living, Person/Family Directed Support, and Adult Autism Waivers during the COVID-19 pandemic. ODP anticipates updating this document on an ongoing basis.

All ISPs revised as a result of COVID-19 must include the following language in the service note:

The changes made to this plan to services, the amount of service, or when services are delivered are being made to ensure participant health and safety during the COVID-19 emergency. These changes are time limited. When the COVID-19 emergency restrictions are lifted, the plan will be revised to reflect the previously authorized services and service levels. The changes made to the ISP are intended to revert to levels prior to being impacted by COVID-19 and are not subject to fair hearing and appeal requirements.

Questions or comments can be directed to the Regulatory Administration Unit mailbox.

The Pennsylvania Department of Human Services (DHS) is committed to serving vulnerable populations every day and protecting individuals receiving services in a facility licensed by DHS. On March 30, we issued guidance for entities licensed by the following DHS program offices:

  1. Office of Developmental Programs (ODP)
  2. Office of Children, Youth and Families (OCYF)
  3. Office of Child Development and Early Learning (OCDEL)
  4. Office of Mental Health and Substance Abuse Services (OMHSAS)
  5. Office of Long-Term Living (OLTL)/Bureau of Human Services Licensing (BHSL)

In the March 30 guidance, we indicated that DHS will not be conducting any annual renewal inspections until Governor Wolf lifts the current Proclamation of Disaster Emergency for COVID-19 or until such other time set by DHS. However, licensing staff continued to investigate incidents and complaints.

Beginning May 28, DHS will resume annual renewal inspections in alignment with the Governor’s plan to re-open parts of the state. Information about the phases for re-opening can be found at the following link: https://www.governor.pa.gov/process-to-reopen-pennsylvania/.

All DHS program offices listed above will resume annual renewal inspections for counties that transition to the “green” phase. OCYF, OCDEL, ODP and OMHSAS will also start some annual renewal inspections for all counties that have transitioned to the “yellow” phase.

Licensing staff from all program offices will continue to investigate incidents and complaints statewide.
DHS is also considering conducting some annual renewal inspections remotely through virtual means.

More information about this will be forthcoming prior to any use of remote inspections. Please contact your Regional Program Office with any questions you may have.