24-456 HCPCS Coding Guidance for Select Community Supports Housing Services
Date: 05/06/24
Proper coding of services assists in getting consistent outreach data to advocate for future fee structures
In January 2024, the Department of Health Care Services (DHCS) updated the Community Supports Healthcare Common Procedure Coding System (HCPCS) coding guidance. Per DHCS guidelines, managed care plans must report the HCPCS code and modifier combinations for outreach efforts on the following housing services, including for both successful and unsuccessful outreach efforts.
- Housing Transition and Navigation
- Housing Deposits
- Housing Tenancy and Sustaining Community Support Services
HCPCS code and modifier combinations guidance
Community Supports providers who are contracted to deliver services listed above are required to submit the HCPCS code and modifier combinations, listed in the table below, to the Plan.
Community Supports providers should submit HCPCS codes and modifier combinations based on whether the outreach was conducted in-person or telephonically, adhering to the Rule of Eights1. Do not report ongoing outreach efforts once a member has been enrolled in a Community Supports housing service.
The new Community Supports HCPCS codes will not impact your existing contracts and the Plan will generate the following automatic response upon claim submission: “Pay $0.00, no contract allowed, for reporting purposes.”
HCPCS Code | HCPCS Description | Modifier | Modifier Description |
|---|---|---|---|
T1016 | Community Supports in-person outreach per 15 minutes for:
| U8 | Used with HCPCS code T1016 to indicate in-person outreach efforts in 15 minutes increments for the purpose of connecting with a member for the initiation of housing Community Supports services indicated. Must be used for both successful and unsuccessful outreach efforts. |
T1016 | Community Supports telephonic/electronic Outreach per 15 minutes for:
| U8, GQ | Used with HCPCS code T1016 to indicate telephonic/electronic outreach efforts in 15 minutes increments for the purpose of connecting with a member for the initiation of housing Community Supports services indicated. Telephonic/electronic methods can include text messaging or secure email individualized to the member. However, mass communications (e.g., mass mailings, distribution emails, and text messages) do not count as outreach and should not be included. Must be used for both successful and unsuccessful outreach efforts. |
1At least eight minutes of treatment must occur to bill for the first 15-minute increment, and for each subsequent 15-minute increment thereafter.
Additional information
If you have questions regarding the information contained in this update, contact CalViva Health at 888‐893‐1569.
This information applies to Community Supports (CS) Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.