Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street Boston, MA 02111 www.mass.gov/dma

MASSHEALTH
TRANSMITTAL LETTER AFC-9 January 2003
TO:      Adult Foster Care Providers Participating in MassHealth
FROM:      Wendy E. Warring, Commissioner
RE:     Adult Foster Care Manual (Changes to Service Codes and Descriptions)
This letter transmits revisions to the list of MassHealth-covered service codes and descriptions in Subchapter 6 of the Adult Foster Care Manual. These revisions are effective for dates of service on and after February 1, 2003.
The Centers for Medicare and Medicaid Services (CMS) have revised the Healthcare Common Procedure Coding System (HCPCS) for 2002. The Division is replacing MassHealth local codes with new national procedure codes to ensure that the Division’s coding requirements are compliant with HIPAA (the Health Insurance Portability and Accountability Act of 1996). Please note that you must use a modifier in some cases to accurately reflect the service provided. The modifier must be entered directly after the service code in Item 28 of claim form no. 9 or its electronic equivalent. The attached Subchapter 6 contains codes with modifiers, where applicable.
Billing Guidelines
What follows is a crosswalk table describing changes from local “X” codes to the new codes.

Current AFC Service Code	New National AFC Service Code	New National AFC Service Description	Effective Date	
X9874	S5140	Foster care, adult; per diem (adult foster care personal care and administration; per diem)	02/01/2003	
X9873	S5140-TF (modifier)	Foster care, adult, per diem (adult foster care short-term alternate placement; per diem for caregiver)	02/01/2003	
If you have any questions about this transmittal letter or how to bill with a modifier, please contact MassHealth Provider Services at 617-628-4141 or 1-800-325-5231.

MASSHEALTH
TRANSMITTAL LETTER AFC-9 January 2003 Page 2
NEW MATERIAL
(The pages listed here contain new or revised language.)
Adult Foster Care Manual
Pages 6-1 and 6-2
OBSOLETE MATERIAL
(The pages listed here are no longer in effect.)
Adult Foster Care Manual
Pages 6-1 and 6-2— transmitted by Transmittal Letter AFC-7

Commonwealth of Massachusetts
Division of Medical Assistance
Provider Manual Series
ADULT FOSTER CARE MANUAL	SUBCHAPTER NUMBER AND TITLE
6 SERVICE CODES AND DESCRIPTIONS	PAGE
6-1	

	TRANSMITTAL LETTER
AFC-9	DATE
02/01/03	
601 Service Codes and Descriptions
Service
Code	Service Description
S5140	Foster care, adult; per diem (Adult foster care personal care and administration;
per diem)
S5140-TF	Foster care, adult; per diem (Adult foster care short-term alternate placement; per
diem for caregiver)

Commonwealth of Massachusetts
Division of Medical Assistance
Provider Manual Series
ADULT FOSTER CARE MANUAL	SUBCHAPTER NUMBER AND TITLE
6 SERVICE CODES AND DESCRIPTIONS	PAGE
6-2	

	TRANSMITTAL LETTER
AFC-9	DATE
02/01/03	
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