TO:                 CERTIFIED FAMILY HOMES AND RESIDENTIAL AND ASSISTED LIVING FACILITIES

FROM:           Kathleen P. Allyn, Deputy Administrator

Effective July 1, 2004, there was a rate increase for code S5140-U2 (Adult Residential Care) for Certified Family Homes and Residential and Assisted Living Facilities that bill this code. All Residential Care providers will receive a letter notifying them of the new rate for each of their clients.  If you do not receive a letter for a participant living in your facility, please notify your local Regional Medicaid Services unit.  Billing system changes for claims with dates of service on or after July 1, 2004 will be complete by 7/12/04, so providers may submit claims to EDS for this code after that date.

• Approval of service by the Regional Medicaid Services unit is still required prior to delivery of service
• A prior authorization number is not needed for dates of service on or after July 1, 2004 
• A prior authorization number is needed for dates of service prior to July 1, 2004 

If you have any questions about the information in this release, please contact Christine Baylis at 208-364-1891.  Thank you for your continued participation in the Idaho Medicaid program.

KPA/cb