Section 3 / Part 7
Effective Date: April 26, 2005
Service codes in numerical order
001
| 025 | 026
| 027 | 028
| 029 | 030
| 031 | 032
| 110
| 120 | 130
| 140 | 150
| 155 | 170
| 200 | 210
| 220 | 230
| 240 | 245
| 250 | 260
| 270 | 280
| 290 | 320
| 330 | 340
| 350 | 360
| 365 | 370
| 380 | 390
| 410 | 411
| 412 | 413
| 414 | 416
| 417 | 510
| 520 | 525
| 526 | 530
| 540 | 550
| 551
| 552 | 553
| 554 | 560
| 570 | 575
| 580 | 590
| 601
| 602 | 603
| 604 | 605
| 606 | 607
| 609 | 610
| 611 | 612
| 613 | 620
| 621 | 622
| 630 | 655
| 700 | 750
| 800 | 801
| 810 | 820
| 830 | 910
| 915 | 916
| 920 | 930
| 935 | 940
| 950 | 955
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001 Customer Servce
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025 Research Component #1: Referral
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026 Research Component #2: Employment Plan
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027 Research Component #3: IPE/Signed
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028 IPE Case Coordination Component #1: Referral
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029 IPE Case Coordination Component #2: Quarterly Intervals
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030 Purchasing Support Component #1: Referral
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031 Purchasing Support Component #2: Purchase Authorization
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032 Purchasing Support Component #2: Item Delivered
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110 Driver's evaluation
110 Independent living assessment
110 Living skills assessment
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120 Blood level testing
120 CAT scan (computerized axial tomography)
120 Chemical profile
120 CT scans (computed tomography)
120 EKG/ECG
120 Imaging service
120 Lab work
120 MRI (magnetic resonance imaging)
120 Myelogram
120 Panoramic X-ray
120 TB test
120 Urinalysis
120 X-rays
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130 Audiological exam
130 ENT exam
130 Eye exam (initial)
130 Functional capacity evaluation
130 General medical exam
130 Hearing assessment
130 Low vision exam
130 Neurological exam
130 Occupational evaluation
130 Optical exam
130 Orthopedic exam
130 Physical exam
130 Physical therapy evaluation
130 Tympanometry
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140 Addiction recovery summary
140 Addition treatment records
140 Alcohol and drug treatment records
140 Copy charges, hospital
140 Court records
140 Definitive medical summary
140 Doctor's notes
140 Hospital records (medical)
140 Medical history
140 Medical records
140 Mental health center information
140 Patient records
140 Police report
140 Post secondary school records
140 Probation or parole reports
140 Psychiatric hospitalization records
140 Psychiatrist’s notes
140 Psychological records
140 Psychotherapy notes
140 Transcripts
140 Treatment records
140 Written medical summary
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150 Achievement testing
150 Aptitude testing
150 CDC assessment
150 Interest testing
150 Situational assessment
150 Vocational assessment
150 Vocational evaluation
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155 CBWA
155 Client compensation for CBWA participation
155 Payment to provider to set-up a CBWA, monitor site, and report
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170 Addiction evaluation
170 Alcohol or drug assessment
170 Definitive psychiatric summary
170 Intelligence testing
170 Mental status exam
170 Neuropsychological assessment
170 Personality assessment
170 Psychiatric diagnostic exam
170 Psychological testing
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200 Health insurance payment
200 Medical insurance premium
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210 Co-pay for prescription
210 Diabetic testing supplies
210 Insulin
210 Non-prescription medication
210 Over the counter (OTC) medication
210 Pharmacy supplies
210 Pill dispenser
210 Prescription medication
210 Syringes
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220 Assistant surgeon charge
220 Cataract surgery
220 Chemotherapy
220 Dialysis
220 Laser surgery
220 Pain management treatment
220 Surgeon fees
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230 Anesthesiologist fee
230 Anesthesiology charge
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240 Follow-up eye exam
240 Follow-up visit with Dr
240 Physician's office visit
240 Recheck
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245 Appendectomy
245 Intercurrent illness
245 Treatment for broken bone
245 Treatment of flu
245 Treatment of intercurrent illness
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250 Emergency room charge
250 Hospital fee
250 Inpatient care
250 Outpatient hospitalization
250 Recovery room charges
250 Room charges
250 Surgery hospital supplies
250 Surgical care
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260 Chiropractor fees
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270 Braille labeler
270 Brailler
270 Cane, folding
270 CCTV
270 Contact lenses
270 Digital voice recorder
270 Dome magnifier
270 Glasses
270 Large print overlay
270 Lens
270 Low vision magnifier
270 Recorder
270 Screen readers
270 Speak dictionary
270 Talking calculator
270 Talking compass
270 Talking watch
270 Tinted lenses
270 Video magnifier
270 Visual aids
270 White cane
270 Zoom text
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280 Crown
280 Dental exam
280 Dental services
280 Fillings
280 Orthodontic repairs
280 Root canal
280 Teeth cleaning
280 Tooth extraction
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290 Alert baby cry signaler
290 Amplifier, telephone
290 Batteries for hearing aid
290 Doorbell amplifier
290 Ear molds
290 Flasher alarm
290 Hearing aids
290 Signalers
290 Sonic boom alarm clock
290 TTD
290 TTY
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320 Psychiatric medication check
320 Psychiatric services
320 Psychiatric therapy sessions
320 Psychiatric treatment
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330 Addiction treatment
330 Alcohol/Drug treatment
330 Drug screening/urinalysis
330 Recovery services
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340 Counseling sessions (treatment by qualified person)
340 Group therapy
340 Individual therapy
340 Mental health center services
340 Psychotherapy (other than psychiatrist)
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350 Electrical stimulation
350 Occupational therapy
350 Physical therapy
350 Therapeutic exercise
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360 Speech therapy
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365 Counseling (General)
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370 Counseling (substantial) by a rehabilitation counselor
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380 Artificial limb
380 Bridges, dental
380 Dentures
380 Eye, prosthetic
380 Partial denture
380 Prosthesis
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390 Braces
390 Cane (for support)
390 Compression stocking
390 Crutches
390 Orthotic shoes
390 Shoe Inserts
390 Sit/stand stool
390 Special shoes (foot conditions)
390 Support stocking
390 Walker
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410 Back cushion
410 Bath lift
410 Communication boards
410 Docking stand
410 Large print measuring cups
410 Liquid level indicator
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411 Custom seating
411 Footplates
411 Power wheelchair
411 Three wheel scooter
411 Wheelchair, manual
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412 Chairlift
412 Hand controls
412 Power door conversion
412 Vehicle accessibility modifications
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413 Computers
413 Disks
413 Hardware, computer
413 Keyboard
413 Motherboards
413 Mouse arm
413 Power supply
413 Printer
413 Scanner
413 Software, computer
413 Wrist rest
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414 Accessibility remodeling
414 Door widening
414 Grab bar installation
414 Ramp installation
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416 Computer repair
416 Hearing aid repair
416 Hearing aid re-programming
416 Repair CCTV
416 Service calls for equipment repairs
416 Wheelchair parts
416 Wheelchair repair
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417 Assistive technology assessment
417 Fitting of prosthesis
417 Hearing aid dispensing fee
417 Job site modification
417 Prosthesis fitting
417 Wheelchair modification
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510 Admissions fee
510 College/University tuition/fees
510 Community college
510 Junior college program
510 Post-secondary degree program
510 Registration fee for school
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520 GED classes
520 GED skills training
520 Schools for the blind and visually impaired
520 Schools for the deaf
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525 Wilson Reading System instruction - KC Region only
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526 Road to Success classes- KC Region only
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530 Barber school
530 CNA training through area vo-tech
530 Computer skills training - work related
530 Cosmetology training
530 Diesel mechanics training
530 Payment for non-degree post-secondary education
530 Technical Drafting
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540 Books
540 Calculator for class
540 Camera equipment for class
540 Cap and gown
540 Class supplies (e.g. art, photography)
540 Day planners
540 Parking permits
540 School supplies
540 Textbooks
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550 Braille training
550 Dyslexia remediation
550 Job preparedness training
550 Job readiness training
550 Job success classes
550 Mobility training
550 Orientation and mobility training
550 Remedial training
550 Supported education
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551 Work Training with Placement Component #1: Development of Plan
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552 Work Training with Placement Component #2: Completion of Plan Objective
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553 Work Training with Placement Component #3: Placement in Permanent
Job
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554 Work Training with Placement Component #4: Successful Closure
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560 OJT
560 On job training
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570 Comprehensive job coaching
570 Job coaching / placement
570 Job coaching on the job that includes finding the job
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575 Job coaching on the job that does not include finding the job
575 Job coaching only
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580 CNA training (from employer)
580 OTAP training
580 Peer specialist training
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590 Independent living skills training
590 Living skills training
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601 Supported Employment-3 Component #1: Job Seeking
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602 Supported Employment-3 Component #2: Job Placement
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603 Supported Employment-3 Component #3: Successful CLosure
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604 Supported Employment-4 Component #1: Referral
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605 Supported Employment-4 Component #2: Job Placement
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606 Supported Employment-4 Component #3: Stabilization
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607 Supported Employment-4 Component #4: Successful Closure
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609 Special accommodation fee for job placement - KC Region only
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610 Comprehensive job placement
610 Employer contacts
610 Employer development
610 Interview skills development
610 Interviewing skills development
610 Job development
610 Job finding
610 Job finding/retention
610 Job placement
610 Resume preparation
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611 Job Placement Services Component #1: Job Seeking
611 Payment-for-performance job seeking
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612 Job Placement Services Component #2: Job Placement
612 Payment-for-performance job placement
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613 Job Placement Services Component #3: Successful Closure
613 Payment-for-performance successful closure
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620 Clippers
620 Mechanic's tools for job
620 Tool chest
620 Trimmers
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621 Commercial driver's license
621 Driver's license fee
621 Nursing license
621 Occupational license
621 Social work license renewal
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622 Accounting services
622 Advertising
622 Business startup expenses
622 Deposit on business property
622 Internet services for business
622 Liability insurance for business
622 Office supplies for business
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630 CPR training
630 Driver education course
630 Driver training (learning to drive)
630 Tutor
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655 CBJT
655 Community based job tryout
655 Compensation to client for participating in a job tryout
655 Payment to provider to set-up a tryout, monitor the tryout, and report
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700 Dorm costs
700 Enrichment activities while in school, such as: Club dues (degree
related) while in school; field trips (extra cost); honor society dues.
700 Haircuts (for interviews, jobs)
700 Interview clothes
700 Living expenses during plan
700 Maintenance
700 Rent deposits
700 Room/board while at school
700 Utility deposit / payment
700 Work clothes
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750 Emergency food/shelter for eligible individuals
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800 Bus coupons
800 Cab tickets
800 Fuel charge
800 Gas money
800 Meals for drivers
800 Mileage for clients
800 Relocation expense connected to job placement significant distance
away
800 Taxi
800 Transportation payments to clients
800 Travel expense for personal care attendant
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801 Mileage for vendors
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810 Kansas sales tax
810 Vehicle purchase (car, van, truck)
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820 Insurance (vehicle)
820 Liability insurance
820 Personal property tax, vehicle
820 Registration fee for vehicle
820 Tags
820 Vehicle inspection
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830 Labor and parts
830 Repair estimate
830 Tires, automotive
830 Towing charges
830 Vehicle repair
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910 Foreign language interpreters
910 Language interpreter
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915 Note taking
915 Oral interpretation
915 Real-time captioning
915 Sign language interpreters
915 Tactile interpretation
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916 Sign language interpreter reimbursement for travel time
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920 Reader services
920 Reading aloud
920 Sound recording of print
920 Transcription of print to Braille
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930 Attendant services
930 Bathing
930 Dressing (assistance)
930 Feeding
930 Mobility support
930 Personal care attendant
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935 Assistive animals
935 Drivers
935 Guide dog
935 Note taking other than interpreters
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940 Veterinarian services for assistive animal
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950 Training in personal care techniques
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955 After school care
955 Babysitters
955 Childcare
955 Childcare tuition
955 Daycare
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