Billing support data provides the information necessary to bill for all adult Health Home rate codes, including the program’s standard Health Home codes (1873-74), outreach code (1862), Health Home Plus rate code (1853), and Adult Home Plus rate codes (1860, 1861).
The billing support questionnaire includes programmatic questions regarding core services, Health Home plus, ACT services, and qualification for Adult Home Plus care management rates. When completing billing support, CMA users must ensure that answers to these questions account for the policy guidelines surrounding each related program and rate code. For details, please refer to the following guidance:
- Standard Health Home Services
- Health Home Plus
- Adult Home Plus
The billing support questionnaire also includes clinical questions regarding patients’ diagnoses, HIV status, housing status, recent incarceration, recent mental illness inpatient stays, and substance use. When completing billing support, CMA users must ensure that answers to these questions are accurate. The responses from both the programmatic and clinical questions are used to determine the appropriate rate code to assign to the patient for the month in question. For more information on how the rate code is determined for each patient, see the following guidance issued by the Department of Health:
Note: Health Home rate codes prior to 10/2018 included the program’s standard HARP and non-HARP codes (1854 – 1859), outreach code (1862), Health Home Plus rate code (1853), and Adult Home Plus rate codes (1860, 1861).