Adult Day Support (ADS) and Vocational Habilitation (VH) Payments

In DODD’s newest update, they shared that they will resume using ADS and VH rates that are associated with acuity group assignments effective September 1, 2021. This change will not affect the rates or billing codes for STEP services. Please see detailed DODD guidance below.

Adult Day Support (ADS) and Vocational Habilitation (VH) Payments

The Ohio Department of Developmental Disabilities (DODD) will resume using the ADS/VH rates associated with the acuity group assignment for each person receiving services effective September 1, 2021. Providers may continue to use the Restart billing codes for ADS/VH services delivered on or before August 31, 2021. For services delivered on or after September 1, 2021, providers should use the traditional ADS/VH billing codes.

DODD has received confirmation from the Centers for Medicare and Medicaid (CMS) that this change does not constitute a violation of their guidance related to the maintenance of effort requirements in the American Recovery Plan Act.

It is not necessary for individual services plans (ISPs) and Payment Authorizations for Waiver Services (PAWS) to be updated prior to September 1, 2021, for providers to be properly reimbursed. ADS and VH services are represented on the PAWS by roll-up codes rather than by distinct billing codes, therefore, as long as ADS and/or VH services are authorized in the ISP, the billing system will look for the associated roll-up code on the PAWS to properly process claims.

STEP billing rates and codes will remain in place and are unaffected by this guidance.

Check DODD’s website for the latest provider news and guidance.

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