HCPCS Range Waiver Services

• 1 Habilitation, educational; waiver, per diem ( T2012 )

• 2 Habilitation, educational, waiver; per hour ( T2013 )

• 3 Habilitation, prevocational, waiver; per diem ( T2014 )

• 4 Habilitation, prevocational, waiver; per hour ( T2015 )

• 5 Habilitation, residential, waiver; per diem ( T2016 )

• 6 Habilitation, residential, waiver; 15 minutes ( T2017 )

• 7 Habilitation, supported employment, waiver; per diem ( T2018 )

• 8 Habilitation, supported employment, waiver; per 15 minutes ( T2019 )

• 9 Day habilitation, waiver; per diem ( T2020 )

• 10 Day habilitation, waiver; per 15 minutes ( T2021 )

• 11 Case management, per month ( T2022 )

• 12 Targeted case management; per month ( T2023 )

• 13 Service assessment/plan of care development, waiver ( T2024 )

• 14 Waiver services; not otherwise specified (NOS) ( T2025 )

• 15 Specialized childcare, waiver; per diem ( T2026 )

• 16 Specialized childcare, waiver; per 15 minutes ( T2027 )

• 17 Specialized supply, not otherwise specified, waiver ( T2028 )

• 18 Specialized medical equipment, not otherwise specified, waiver ( T2029 )

• 19 Assisted living, waiver; per month ( T2030 )

• 20 Assisted living; waiver, per diem ( T2031 )

• 21 Residential care, not otherwise specified (NOS), waiver; per month ( T2032 )

• 22 Residential care, not otherwise specified (NOS), waiver; per diem ( T2033 )

• 23 Crisis intervention, waiver; per diem ( T2034 )

• 24 Utility services to support medical equipment and assistive technology/devices, waiver ( T2035 )

• 25 Therapeutic camping, overnight, waiver; each session ( T2036 )

• 26 Therapeutic camping, day, waiver; each session ( T2037 )

• 27 Community transition, waiver; per service ( T2038 )

• 28 Vehicle modifications, waiver; per service ( T2039 )

• 29 Financial management, self-directed, waiver; per 15 minutes ( T2040 )

• 30 Supports brokerage, self-directed, waiver; per 15 minutes ( T2041 )