Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.05-086 - ElderChoices Home and Community-Based 2176 Waiver Provider Manual Update Transmittal #55

Current through Register Vol. 49, No. 6, June, 2024
213.400
Personal Emergency Response System
Procedure Code
Required Modifier
Description
S5161
UA
PERS Unit
S5160
-
PERS Installation
The Personal Emergency Response System (PERS) is an in-home,
				24-hour electric support system with two-way verbal and electronic
				communication with an emergency control center. PERS enables an elderly, infirm
				or homebound individual to secure immediate help in the event of a physical,
				emotional or environmental emergency.
PERS is specifically designed for
high-risk
				individuals
whose needs have been carefully determined by the DHHS
				RN based on their level of medical vulnerability, functional impairment and
				social isolation.
PERS is not intended to be a universal
				benefit
. The DHS RN must verify that the individual is capable,
				both physically and mentally, of operating the PERS unit.
PERS must be prescribed by the client's attending physician and
				must be included in the client's written plan of care.
PERS providers must contact each client at least once per month
				to test the system's operation. The provider shall maintain a log of test calls
				that includes the date and time of each test, specific test results, corrective
				actions and outcomes.
A log of all client calls received must be maintained by the
				emergency response center. The log must reflect the date, time and nature of
				each call and the response initiated by the center. All calls must be
				documented in the client's record. See section
				214.000 for other documentation
				requirements.
One (1) unit of service equals one (1) day. PERS is limited to
				a maximum of thirty-one (31) units per month.
The installation of PERS will be allowed once per lifetime or
				period of eligibility. Claims submitted for the installation of PERS should use
				procedure code
S5160.
Procedure code
S5160
may be
				billed for ElderChoices clients who are accessing PERS services for the first
				time or for the current period of re-eligibility for ElderChoices Waiver
				Services. In the event of extenuating circumstances that result in the need for
				reinstallation, the provider may contact the Division of Aging and Adult
				Services for extension of the benefit.
View or print Division of Aging and Adult
				Services contact information.
262.100 HCPCS Procedure Codes
The following procedure codes must be billed for ElderChoices
				Services:
Procedure Code
Required Modifier
Description
Unit of Service
POS for
Paper
Claims
POS for
Electronic
Claims
S5140
-
Adult Foster Care
1 day
0
99
S5130
-
Homemaker Services
15 min
4
12
S5170
U2
Home-Delivered Meals
1 meal
4
12
S5161
UA
Personal Emergency Response System
1 day
4
12
S5100
-
Adult Day Care 6 to 8 hours per date of
						  service
15 min
5
52
S5100
TD
Adult Day Health Care 6 to 8 hours per date of
						  service
15 min
5
52
T1005
-
Respite Care - Long-term Facility-Based
15 min
1
or
7
21 or 33
S5120
-
Chore Services
15 min
4
12
S5135
-
Respite Care - Short-term Facility-Based
15 min
5,1,7
52,21,33
S5150
-
Respite Care - In-Home
15 min
4
12
S5100
TD, U1
Adult Day Health Care 4 or 5 hours per date of
						  service
15 min
5
52
S5100
U1
Adult Day Care 4 or 5 hours per date of
						  service
15 min
5
52
S5170
ET
Emergency Home Delivered Meals
1 meal
4
12
S5160
"
Personal Emergency Response System
						  -Installation
1 installation
4
12
S5170
-
Frozen Home-Delivered Meal
1 meal
4
12