Effective retroactively to May 1, 2006, new guidelines have been implemented for Adult Day Health Care (ADHC) providers to clarify number of days and carry-over days.

Number of Days
The Medi-Cal field office authorizes ADHC services on the basis of a specific number of days per calendar month. The ADHC medical provider should specify the months and number of requested days for each calendar month on separate lines of the Treatment Authorization Request (TAR). For example, for a six-month request, there should be six lines filled in on the TAR.

• The TAR will continue to authorize a total number of days for up to six months.
• The ADHC provider should continue to note the number of planned days per week on the TAR.

The ADHC provider may schedule attendance of the participant authorized for ADHC services on any day(s) during the month as long as the total number of days attended by the participant during the month does not exceed the number of units authorized on the TAR for that calendar month, except for carry-over days.

Claims for ADHC services will not be reimbursed for days in excess of the number of days per calendar month authorized on the TAR, except for carry-over days. Claims for any day(s) not authorized on the TAR for that calendar month will be denied, except for carry-over days.

Carry-Over Days
Carry-over days must be billed on the final claim of the month in which the carry-over day(s) was used. For a billing example, see the Adult Day Health Care (ADHC) Centers Billing Examples section.

This information is reflected on manual replacement pages adu tar ipc 5 thru 7 (Part 2).