Part 2 - Community–Based Adult Services



Appeal Form Completion (appeal form) (Revision Date May 29, 2020) | (792KB)
Audiological Services (audio) (Revision Date May 29, 2020) | (176KB)
Audiological Services Billing Example: UB-04 (audio exu) (Revision Date May 29, 2020) | (238KB)
CIF Completion (cif co) (Revision Date May 29, 2020) | (813KB)
CIF Submission and Timeliness Instructions (cif sub) (Revision Date May 29, 2020) | (138KB)
Community-Based Adult Services (CBAS) (community) (Revision Date May 29, 2020) | (159KB)
Correct Coding Initiative: National (correct) (Revision Date Jul 16, 2020) | (101KB)
Forms: Legibility and Completion Standards (forms leg) (Revision Date May 29, 2020) | (99KB)
Forms Reorder Request: Guidelines (forms reo) (Revision Date May 29, 2020) | (86KB)
HCPCS Introduction (hcpcs) (Revision Date May 29, 2020) | (79KB)
Occupational Therapy (occu) (Revision Date May 29, 2020) | (142KB)
Occupational Therapy Billing Example: UB-04 (occu exu) (Revision Date May 29, 2020) | (249KB)
Other Health Coverage (OHC) (oth hlth) (Revision Date May 29, 2020) | (137KB)
Physical Therapy (phys) (Revision Date May 29, 2020) | (95KB)
Physical Therapy Billing Example: UB-04 (phys exu) (Revision Date May 29, 2020) | (247KB)
Physician-Administered Drugs: NDC (physician ndc) (Revision Date Jul 16, 2020) | (136KB)
Remittance Advice Details (RAD) (remit adv) (Revision Date May 29, 2020) | (141KB)
Sign Language Interpretation (sign) (Revision Date May 29, 2020) | (200KB)
Speech Therapy (speech) (Revision Date May 29, 2020) | (123KB)
Speech Therapy Billing Example: UB-04 (speech exu) (Revision Date May 29, 2020) | (232KB)
TAR Completion (tar comp) (Revision Date May 29, 2020) | (288KB)
TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer) (Revision Date May 29, 2020) | (479KB)
TAR Field Office Addresses (tar field) (Revision Date May 29, 2020) | (260KB)
TAR Submission: Transmittal Form (tar submis) (Revision Date May 29, 2020) | (258KB)
TAR: Submitting Appeals (tar submit) (Revision Date May 29, 2020) | (86KB)
UB-04 Completion: Outpatient Services (ub comp op) (Revision Date May 29, 2020) | (330KB)
UB-04 Submission and Timeliness Instructions (ub sub) (Revision Date May 29, 2020) | (160KB)
UB-04 Tips for Billing: Outpatient Services (ub tips op) (Revision Date May 29, 2020) | (130KB)


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