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Corrected Rate Update for AIDS Waiver Program

April 30, 2018

In a previous Medi-Cal Update published April 2018, the reimbursement rates for several HCPCS and CPT-4 codes were updated for the AIDS Medi-Cal Waiver Program (MCWP) in error. The correct reimbursement rates, effective retroactively for dates of service on or after July 1, 2017, are as follows:

CPT-4 or
HCPCS Code
Description Maximum Rate
90837 Psychotherapy, 60 minutes with patient $   98.02
per hour
90846 Family psychotherapy (without the patient present), 50 minutes 98.02
per hour
90847 Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes 98.02
per hour
G0156 Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes 9.52
per 15 minutes
G0299 Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes 19.27
per 15 minutes
G0300 Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes 13.97
per 15 minutes
S5130 Homemaker service, not otherwise specified (nos); per 15 minutes 7.07
per 15 minutes
S9470 Nutritional counseling, dietitian visit 63.61
per hour
T2003 Nonemergency transportation; encounter/trip 100.00
per client per month
T2022 Case management, per month 363.23
per client per month
T2025 Waiver services; not otherwise specified (nos) 246.91
per client per month

The Part 2 AIDS Waiver Program manual will be updated to reflect the correct reimbursement rates in an upcoming Medi-Cal Update. An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims. These rates are exclusive for AIDS MCWP.