Included in CFR Manual Only - New York State Office of Mental Health

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New York State Consolidated Budget and Claiming Manual Subject: Appendix G – OPWDD Program Types, Definitions and Codes For the Periods: January 1, 2010 to December 31, 2010 July 1, 2010 to June 30, 2011 Section/Page: 31.36 Issued: February 15, 2010 5091 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled, Day Training (Not Operated by Service Provider) When VOICF/DD consumers attend a Day Training program that is not operated by the service provider, the increased portion of the rate and the associated expenses are to be reported in a discreet column under program code 5091 (VOICF/DD, Day Training) using the operating certificate number of the ICF as the program/site identification number. Report revenue as “Medicaid” and expense as “OTPS-Other”. Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 5091 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported. Units of Service: One day equals one unit of service. 6090 - Day Program Services Included in the ICF/DD Reimbursement Rate (On-Site) Day program services for ICF/DD (Program Code 0090 and 1090) consumers whose comprehensive functional assessments require that such services be delivered by the ICF/DD and the funding for these services is included in the ICF/DD rate. When an ICF/DD has reimbursement for Day Program Services provided by the ICF/DD included in its rate, the associated expenses of the day program are to be reported in a discreet column under Program Code 6090 using the operating certificate of the ICF/DD as the program/site identification number. The revenue is reported as Medicaid and the expense is reported using all applicable expense line items. Do not report Sheltered Workshop, School District Contract, or Day Training Expenses included in an ICF/DD rate under Program Code 6090. These should be reported using Program Codes 2090, 2091, 3090, 3091, 5090 or 5091. Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 6090 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported. Units of Service: Half-day service: 3 but less than 5 hours. Full-day service: 5 hours or more.
New York State Consolidated Budget and Claiming Manual Subject: Appendix G – OPWDD Program Types, Definitions and Codes For the Periods: January 1, 2010 to December 31, 2010 July 1, 2010 to June 30, 2011 Section/Page: 31.37 Issued: February 15, 2010 6091 - Day Program Services Included in the ICF/DD Reimbursement Rate (Off-Site) Day program services for ICF/DD (Program Code 0090 and 1090) consumers whose comprehensive functional assessments require that such services be delivered by other than the ICF/DD and the funding for these services is included in the ICF/DD rate. When an ICF/DD has reimbursement for Day Program Services provided by other than the ICF/DD included in its rate, the associated expenses of the day program are to be reported in a discreet column under Program Code 6091 using the operating certificate of the ICF/DD as the program/site identification number. Do not report Sheltered Workshop, School District Contract, or Day Training Expenses included in an ICF/DD rate under Program Code 6091. These should be reported using Program Codes 2090, 2091, 3090, 3091, 5090 or 5091. If the service provider operates both the ICF/DD and the day program service, the expense is reported using all expense lines. If the service provider does not operate the day program service, the expense should be reported as “OTPS-Other”. The revenue is reported as Medicaid. Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 6091 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported. Units of Service: Half-day service: 3 but less than 5 hours. Full-day service: 5 hours or more. 7090 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled, Day Services Contract This Program Code should be used when the ICF/DD rate includes an add-on for day programming services where the provider of day program service bills OPWDD directly. When the service provider operates both the VOICF/DD and the Day Service program, the increased portion of the rate and the associated expense is to be reported in this discreet column using the operating certificate number of the VOICF/DD as the program/site identification number. The revenue is reported as Medicaid and the expense is reported using all applicable expense line items. Do not include this revenue and expense in the column used to report the day service program. Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 7090 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.
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Included in CFR Manual Only - New York State Office of Mental Health

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