Primary navigation

    CFSS codes and rates

    See: Long-Term Services and Supports Service Rate Limits Effective Oct. 1, 2024 (PDF)

    Agency model

    Service name Procedure code Mod 1 Mod 2 Mod 3 Mod 4 10/1/24 rate
    CFSS extended personal care agency (1:1) T1019 U9 UC - - $5.95
    CFSS extendedpersonal care agency, shared care (1:2) T1019 U9 UC UN - $4.47
    CFSS extended personal care agency, shared care(1:3) T1019 U9 UC UP - $3.92
    CFSS extended personal care agency, complex (1:1) T1019 U9 UC TG - $6.39
    CFSS extended personal care agency, shared care, complex (1:2) T1019 U9 UC UN TG $4.80
    CFSS extended personal care agency, shared care, complex (1:3) T1019 U9 UC UP TG $4.21
    CFSS personal care reduction agency (1:1) T1019 U9 U5 - - $5.95
    CFSS personal care reduction agency, shared care (1:2) T1019 U9 U5 UN - $4.47
    CFSS personal care reduction agency, shared care (1:3) T1019 U9 U5 UP - $3.92
    CFSS personal care reduction agency, complex (1:1) T1019 U9 U5 TG - $6.39
    CFSS personal care reduction agency, shared care, complex (1:2) T1019 U9 U5 UN TG $4.80
    CFSS personal care reduction agency, shared care, complex (1:3) T1019 U9 U5 UP TG $4.21
    CFSS personal care agency (1:1) T1019 U9 - - - $5.95
    CFSS personal care agency, shared care (1:2) T1019 U9 UN - - $4.47
    CFSS personal care agency, shared care (1:3) T1019 U9 UP - - $3.92
    CFSS personal care agency, complex (1:1) T1019 U9 TG - - $6.39
    CFSS personal care agency, shared care, complex (1:2) T1019 U9 UN TG - $4.80
    CFSS personal care agency, shared care, complex (1:3) T1019 U9 UP TG - $4.21
    CFSS personal care temporary increase agency (1:1) T1019 U9 U6 - - $5.95
    CFSS personal care temporary increase agency, shared care (1:2) T1019 U9 UN U6 - $4.47
    CFSS personal care temporary increase agency, shared care (1:3) T1019 U9 UP U6 - $3.92
    CFSS personal care temporary increase agency, complex (1:1) T1019 U9 U6 TG - $6.39
    CFSS personal care temporary increase agency, shared care, complex (1:2) T1019 U9 U6 UN TG $4.80
    CFSS personal care temporary increase agency, shared care, complex (1:3) T1019 U9 U6 UP TG $4.21
    CFSS personal care continuation of benefits agency (1:1) T1019 U9 U4 - - $5.95
    CFSS personal care continuation of benefits agency, shared care (1:2) T1019 U9 UN U4 - $4.47
    CFSS personal care continuation of benefits agency, shared care (1:3) T1019 U9 UP U4 - $3.92
    CFSS personal care continuation of benefits agency, complex (1:1) T1019 U9 U4 TG - $6.39
    CFSS personal care continuation of benefits agency, shared care, complex (1:2) T1019 U9 UN U4 TG $4.80
    CFSS personal care continuation of benefits agency, shared care, complex (1:3) T1019 U9 UP U4 TG $4.21
    CFSS personal care 45 day temporary start agency (1:1) T1019 U8 - - - $5.95
    CFSS personal care 45 day temporary start agency, shared care (1:2) T1019 U8 UN - - $4.47
    CFSS personal care 45 day temporary start agency, shared care (1:3) T1019 U8 UP - - $3.92
    CFSS personal care 45 day temporary start agency complex (1:1) T1019 U8 TG - - $6.39
    CFSS personal care 45 day temporary start agency, shared care, complex (1:2) T1019 U8 TG UN - $4.80
    CFSS personal care 45 day temporary start agency, shared care, complex (1:3) T1019 U8 TG UP - $4.21
    CFSS goods and services agency (includes fee for FMS) T5999 U9 - - - N/A
    CFSS PERS installation and testing agency S5160 U9 - - - $500
    CFSS PERS monthly service fee agency S5161 U9 - - - $110
    CFSS PERS purchase agency S5162 U9 - - - $1,500
    CFSS worker training & supervision (agencytraining) S5116 U9 - - - $1.272.96
    CFSS worker training and supervision (formal training) S5116 U9 UD - - N/A

    Budget model

    Service name Procedure code Mod 1 Mod 2 Mod 3 Mod 4 10/1/24 rate
    CFSS personal care extended budget (1:1) T1019 UB UC - - N/A
    CFSS personal care extended budget, shared care (1:2) T1019 UB UC UN - N/A
    CFSS personal care extended budget, shared care (1:3) T1019 UB UC UP - N/A
    CFSS personal care extended budget (1:1), complex T1019 UB UC TG - N/A
    CFSS personal care extended budget, shared care, complex (1:2) T1019 UB UC UN TG N/A
    CFSS personal care extended budget, shared care, complex (1:3) T1019 UB UC UP TG N/A
    CFSS personal care reduction budget (1:1) T1019 UB U5 - - N/A
    CFSS personal care reduction budget, shared care (1:2) T1019 UB U5 UN - N/A
    CFSS personal care reduction budget, shared care(1:3) T1019 UB U5 UP - N/A
    CFSS personal care reduction budget, complex (1:1) T1019 UB U5 TG - N/A
    CFSS personal care reduction budget, shared care, complex (1:2) T1019 UB U5 UN TG N/A
    CFSS personal care reduction budget, shared care, complex (1:3) T1019 UB U5 UP TG N/A
    CFSS personal care budget (1:1) T1019 UB - - - N/A
    CFSS personal care budget, shared care (1:2) T1019 UB UN - - N/A
    CFSS personal care budget, shared care (1:3) T1019 UB UP - - N/A
    CFSS personal care budget, complex (1:1) T1019 UB TG - - N/A
    CFSS personal care budget, shared care, complex (1:2) T1019 UB UN TG - N/A
    CFSS personal care budget, shared care, complex (1:3) T1019 UB UP TG - N/A
    CFSS personal care temporary increase budget (1:1) T1019 UB U6 - - N/A
    CFSS personal care temporary increase budget, shared care (1:2) T1019 UB UN U6 - N/A
    CFSS personal care temporary increase budget, shared care (1:3) T1019 UB UP U6 - N/A
    CFSS personal care temporary increase budget, complex (1:1) T1019 UB U6 TG - N/A
    CFSS personal care temporary increase budget, shared care, complex (1:2) T1019 UB U6 UN TG N/A
    CFSS personal care temporary increase, shared care, complex (1:3) T1019 UB U6 UP TG N/A
    CFSS personal care continuation of benefits budget (1:1) T1019 UB U4 - - N/A
    CFSS personal care continuation of benefits budget, shared care (1:2) T1019 UB UN U4 - N/A
    CFSS personal care continuation of benefits budget, shared care (1:3) T1019 UB UP U4 - N/A
    CFSS personal care continuation of benefits budget, complex (1:1) T1019 UB U4 TG - N/A
    CFSS personal care continuation of benefits budget, shared care, complex (1:2) T1019 UB UN U4 TG N/A
    CFSS continuation of benefits budget, shared care, complex (1:3) T1019 UB UP U4 TG N/A
    CFSS goods and services budget T5999 UB - - - N/A
    CFSS PERS installation and testing budget S5160 UB - - - $500
    CFSS PERS monthly service fee budget S5161 UB - - - $110
    CFSS PERS purchase budget S5162 UB - - - $1,500
    CFSS worker training & supervision budget (formal training) S5116 UB UD - - $1,272.96
    CFSS financial management services fee budget T2040 UB UA - - N/A
    CFSS failed background study fee budget T2040 UB UA U6 - $44

    Consultation services

    Service name Procedure code Mod 1 Mod 2 Mod 3 Mod 4 10/1/24 rate
    CFSS consultation services, orientation and annual renewal T1023 - - - - $100
    CFSS consultation services, ongoing support T1023 TS - - - $100
    CFSS consultation services, quality assurance and remediation T1023 U2 - - - $100

    Notes

    • The following modifiers are only used on claims and not entered by the lead agency: 
      • UN
      • UP
      • TS
      • U2
      • UD for a person on the agency model.
    • People cannot do a 45-day temporary start using the budget model and lead agencies cannot authorize a 45-day increase on an extended CFSS services line.
    back to top