Rate Adjustment Approved for TBI CSS

Situation Report | July 6, 2021

As of July 1, 2021 (Medicaid Cycle 2290), approved providers offering Home and Community Support Services (HCSS) in one of seven rural counties as part of the Traumatic Brain Injury (TBI) waiver program are required to submit all initial claims using the new HCSS Rural Rate Code 9883.

On March 24, 2021, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the TBI 1915(c) waiver application No. NY 0269.R04.04, which provides for a rural rate adjustment to the HCSS waiver service, retroactive to September 1, 2019.