Training and Program Planning States may consider combining sample codes 4 and 5 in the Reference Document. Combining training and program administration functions as one code allows staff to focus on whether the activity relates to Medicaid, a non-Medicaid program, or no specific program. Coding for program planning can include activities related to establishing and maintaining documentation, internal processes, and policies related to the provision of LTSS, health care services and other supports. For example, analyzing data to identify and close service gaps, working with partner agencies and planning advisory or interagency committee meetings in order to improve coordination and delivery of services. Additional Codes for Consideration NWD/ADRC staff may receive direct reimbursement for certain Medicaid-related services on a per unit basis. To avoid duplication, States may develop a code for activities reimbursed directly by another source. Activities coded this way include case management services for Medicaid programs, nursing home transition coordination, etc. Consider a code category for general administration or personal time off. This is a way for staff to document when they are conducting “non-work” related activities, such as answering personal phone calls and emails, conducting personnel related activities, such as time sheets/work schedules, payroll or HR activities, etc. A general administration code also accounts for time off away from work, i.e. breaks, lunch, vacation, sick days, holidays, or any other type of leave. Examples Exhibit 2 provides examples of CMS approved codes. The code category refers to the samples provided in Exhibit1. Exhibit 2: State Time Study Codes Code Category Maryland Oregon Wisconsin Outreach Outreach (Medicaid Related, Not Medicaid Related, Not Tied to a Specific Program) Outreach (Medicaid, Food Stamps, OAA, MMA, Other) Medical Services Admin Non-allowable Medical Services Activities Referral, Coordination and Monitoring Referral, Coordination and Monitoring (Medicaid eligible, Individuals at Risk of Institutionalization and NWD Information and Referral Medical Services Coordination (MA)
Medicaid Spend Down, Not Medicaid Related) Medical Services Coordination (Not MA) Eligibility Facilitating Applications (Medicaid related, Not Medicaid related) Level I Screen Assessment Tool Initial Screening Eligibility/Re-Eligibility Determination (Medicaid Program Eligibility, Food Stamp Program, State Programs, Older Americans Act (OAA), Other Programs, Medicare Modernization Act, Part D) Functional Screen Admin Functional Screen (Other) Training Training and Program Administration (Related to Medicaid or a Medicaid Funded Service, Related to a Program or Service that is Not Funded by Medicaid, and Not Tied to a Specific Program) NWD Training MA Activity Training Program Planning, Interagency Coordination and Continuous Quality Improvement Additional Options Counseling(Medicaid or potentially Medicaid, Medicaid Ruled Out as an Option, Follow-up with Medicaid Ruled Out as an Option) Activities Reimbursed by Another Source General Administration NWD Person-Centered Options Counseling General Administration Case identifier Common to All Decision Tree for Choosing Codes To help staff determine which code to pick, a decision tree may provide a useful visual. Exhibit 3 provides an example of a decision tree for Maryland’s time study codes. Staff follow the top row of code categories until they reach the appropriate code. Code categories should follow an