| Service name | Procedure code | Mod 1 | Mod 2 | Mod 3 | Mod 4 |
|---|---|---|---|---|---|
| Agency - CFSS Extended Services (1:1) | T1019 | U9 | UC | - | - |
| Agency - CFSS Extended, Shared Care (1:2) | T1019 | U9 | UC | UN | - |
| Agency - CFSS Extended, Shared Care (1:3) | T1019 | U9 | UC | UP | - |
| Agency - CFSS Extended Services, Complex (1:1) | T1019 | U9 | UC | TG | - |
| Agency - CFSS Extended, Shared Care, Complex (1:2) | T1019 | U9 | UC | UN | TG |
| Agency - CFSS Extended, Shared Care, Complex (1:3) | T1019 | U9 | UC | UP | TG |
| Agency - CFSS Reduction (1:1) | T1019 | U9 | U5 | - | - |
| Agency - CFSS Reduction, Shared Care (1:2) | T1019 | U9 | U5 | UN | - |
| Agency - CFSS Reduction, Shared Care (1:3) | T1019 | U9 | U5 | UP | - |
| Agency - CFSS Reduction, Complex (1:1) | T1019 | U9 | U5 | TG | - |
| Agency - CFSS Reduction, Shared Care, Complex (1:2) | T1019 | U9 | U5 | UN | TG |
| Agency - CFSS Reduction, Shared Care, Complex (1:3) | T1019 | U9 | U5 | UP | TG |
| Agency - CFSS Services (1:1) | T1019 | U9 | - | - | - |
| Agency - CFSS Shared Care (1:2) | T1019 | U9 | UN | - | - |
| Agency - CFSS Shared Care (1:3) | T1019 | U9 | UP | - | - |
| Agency - CFSS Services, Complex (1:1) | T1019 | U9 | TG | - | - |
| Agency - CFSS Services, Shared Care, Complex (1:2) | T1019 | U9 | UN | TG | - |
| Agency - CFSS Services, Shared Care, Complex (1:3) | T1019 | U9 | UP | TG | - |
| Agency - CFSS Temporary Increase (1:1) | T1019 | U9 | U6 | - | - |
| Agency - CFSS Temporary Increase, Shared Care (1:2) | T1019 | U9 | UN | U6 | - |
| Agency - CFSS Temporary Increase, Shared Care (1:3) | T1019 | U9 | UP | U6 | - |
| Agency - CFSS Temporary Increase, Complex (1:1) | T1019 | U9 | U6 | TG | - |
| Agency - CFSS Temporary Increase, Shared Care, Complex (1:2) | T1019 | U9 | U6 | UN | TG |
| Agency - CFSS Temporary Increase, Shared Care, Complex (1:3) | T1019 | U9 | U6 | UP | TG |
| Agency - Continuation of Benefits (1:1) | T1019 | U9 | U4 | - | - |
| Agency - Continuation of Benefits, Shared Care (1:2) | T1019 | U9 | UN | U4 | - |
| Agency - Continuation of Benefits, Shared Care (1:3) | T1019 | U9 | UP | U4 | - |
| Agency - Continuation of Benefits, Complex (1:1) | T1019 | U9 | U4 | TG | - |
| Agency - Continuation of Benefits, Complex, Shared Care (1:2) | T1019 | U9 | UN | U4 | TG |
| Agency - Continuation of Benefits, Complex, Shared Care (1:3) | T1019 | U9 | UP | U4 | TG |
| Agency - CFSS 45 Day Temporary Start | T1019 | U8 | - | - | - |
| Agency - CFSS 45 Day Temporary Start, Complex | T1019 | U8 | TG | - | - |
| Agency - Goods (includes fee for FMS) | T5999 | U9 | - | - | - |
| Agency - PERS Installation and Testing | S5160 | U9 | - | - | - |
| Agency - PERS Monthly Service Fee | S5161 | U9 | - | - | - |
| Agency - PERS Purchase | S5162 | U9 | - | - | - |
| CFSS Worker Training & Development (agency training) | S5116 | U9 | - | - | - |
| CFSS Worker Training and Development (formal training) | S5116 | U9 | UD | - | - |
| Service name | Procedure code | Mod 1 | Mod 2 | Mod 3 | Mod 4 |
|---|---|---|---|---|---|
| Budget - Goods | T5999 | UB | - | - | - |
| CFSS Worker Training & Development (formal training) | S5116 | UB | UD | - | - |
| Budget - CFSS Extended Services (1:1) | T1019 | UB | UC | - | - |
| Budget - CFSS Extended, Shared Care (1:2) | T1019 | UB | UC | UN | - |
| Budget - CFSS Extended, Shared Care (1:3) | T1019 | UB | UC | UP | - |
| Budget - CFSS Extended Services, Complex (1:1) | T1019 | UB | UC | TG | - |
| Budget - CFSS Extended, Shared Care, Complex (1:2) | T1019 | UB | UC | UN | TG |
| Budget - CFSS Extended, Shared Care, Complex (1:3) | T1019 | UB | UC | UP | TG |
| Budget - CFSS Reduction (1:1) | T1019 | UB | U5 | - | - |
| Budget - CFSS Reduction, Shared Care (1:2) | T1019 | UB | U5 | UN | - |
| Budget - CFSS Reduction, Shared Care (1:3) | T1019 | UB | U5 | UP | - |
| Budget - CFSS Reduction, Complex | T1019 | UB | U5 | TG | - |
| Budget - CFSS Reduction, Shared Care, Complex (1:2) | T1019 | UB | U5 | UN | TG |
| Budget - CFSS Reduction, Shared Care, Complex (1:3) | T1019 | UB | U5 | UP | TG |
| Budget - CFSS Services (1:1) | T1019 | UB | - | - | - |
| Budget - CFSS Shared Care (1:2) | T1019 | UB | UN | - | - |
| Budget - CFSS Shared Care (1:3) | T1019 | UB | UP | - | - |
| Budget - CFSS Services, Complex (1:1) | T1019 | UB | TG | - | - |
| Budget - CFSS Services, Shared care, Complex (1:2) | T1019 | UB | UN | TG | - |
| Budget - CFSS Services, Shared Care, Complex (1:3) | T1019 | UB | UP | TG | - |
| Budget - CFSS Temporary increase (1:1) | T1019 | UB | U6 | - | - |
| Budget - CFSS Temporary increase (1:2) | T1019 | UB | UN | U6 | - |
| Budget - CFSS Temporary increase (1:3) | T1019 | UB | UP | U6 | - |
| Budget - CFSS Temporary Increase, Complex (1:1) | T1019 | UB | U6 | TG | - |
| Budget - CFSS Temporary Increase, Shared Care, Complex (1:2) | T1019 | UB | U6 | UN | TG |
| Budget - CFSS Temporary Increase, Shared Care, Complex (1:3) | T1019 | UB | U6 | UP | TG |
| Budget - Continuation of Benefits (1:1) | T1019 | UB | U4 | - | - |
| Budget - Continuation of Benefits, Shared Care (1:2) | T1019 | UB | UN | U4 | - |
| Budget - Continuation of Benefits, Shared Care (1:3) | T1019 | UB | UP | U4 | - |
| Budget - Continuation of Benefits, Complex (1:1) | T1019 | UB | U4 | TG | - |
| Budget - Continuation of Benefits, Complex, Shared Care (1:2) | T1019 | UB | UN | U4 | TG |
| Budget - Continuation of Benefits, Complex, Shared Care (1:3) | T1019 | UB | UP | U4 | TG |
| Budget - PERS Installation and Testing | S5160 | UB | - | - | - |
| Budget - PERS Monthly Service Fee | S5161 | UB | - | - | - |
| Budget - PERS Purchase | S5162 | UB | - | - | - |
| Budget - FMS Fee | T2040 | UB | UA | - | - |
| Budget - Failed background study fee | T2040 | UB | UA | U6 | - |
| Service name | Procedure code | Mod 1 | Mod 2 | Mod 3 | Mod 4 |
|---|---|---|---|---|---|
| Consultation - Orientation/Annual Renewal | T1023 | - | - | - | - |
| Consultation - Ongoing support | T1023 | TS | - | - | - |
| Consultation - QA/Remediation | T1023 | U2 | - | - | - |
| Code | Meaning |
|---|---|
| TG | complex |
| UC | extended |
| U4 | continuation of benefits |
| U5 | reduction |
| U6 | temporary increase |
| U9 | agency model |
| UB | budget model |
| UN | 1:2 shared care (goes on claims only) |
| UP | 1:3 shared care (goes on claims only) |
| UD | training classes (claims only for agency model, claims and service agreement for budget model) |
Notes: You can’t do a 45 day temporary start in the budget model. There is no extended code for the 45 day temporary increase (T1019 U9/UB U6).
