<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000001 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sd33d86ea-dc29-44a9-9a84-097b420e0e7a000002 { color: black; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } table.sd33d86ea-dc29-44a9-9a84-097b420e0e7a000003 { border-collapse: collapse; border: none; margin-left: 32.4pt; margin-bottom: .001pt; } td.sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004 { vertical-align: top; width: 144pt; border-top: none; border-right: none; padding-right: 5.4pt; border-bottom: none; border-left: none; padding-left: 5.4pt; padding-top: 0; padding-bottom: 0; } td.sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005 { vertical-align: top; width: 279pt; border-top: none; border-right: none; padding-right: 5.4pt; border-bottom: none; border-left: none; padding-left: 5.4pt; padding-top: 0; padding-bottom: 0; } span.sd33d86ea-dc29-44a9-9a84-097b420e0e7a000006 { color: black; background: white; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000007 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">    </span><a href="https://sdlegislature.gov/Rules?Rule=67:54:09:18"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000000">67:54:09:18</span></a><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000001">.  Billing requirements.</span><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0"> A claim submitted for payment under this chapter </span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">must</span><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0"> contain the following </span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Health Care Common Procedure Coding System</span><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0"> procedure codes, as applicable.</span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000002"> </span></p><div align="left"><table dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000003"><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000001">PROCEDURE CODE</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000001">DESCRIPTION</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000006"> </span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000006"> </span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">T1020</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Companion care</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">S5165</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Home modifications</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">B4222</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Nutritional supplements</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">T1005</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Respite care</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">T1016</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Service coordination</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">T1019</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Personal care</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">T2018</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Supported employment</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">A9900</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Specialized medical adaptive equipment and supplies</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">T2039</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Vehicle modifications</span></p></td></tr><tr><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000004"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">G0154</span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">G0176</span></p></td><td class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000005"><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Personal Care 2</span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Specialized Therapies</span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000002"> </span></p></td></tr></table></div><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000002"> </span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">    </span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000001">Source:</span><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0"> 34 SDR 271, effective May 7, 2008; SL 2013, ch 128, § 37, effective July 1, 2013</span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">; 50 SDR 63, effective November 27, 2023</span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">.</span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">    </span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000001">General Authority:</span><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000007">28-6-1</span></a><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">.</span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">    </span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000001">Law Implemented:</span><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000007">28-6-1</span></a><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">.</span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000002"> </span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">    </span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000001">Cross-Reference:</span><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0"> Use of </span><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">Health Care Common Procedure Coding System</span><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">, § </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:01:27"><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0-000007">67:16:01:27</span></a><span class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aC0">.</span></p><p dir="ltr" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7aP0"><span xml:space="preserve" class="sd33d86ea-dc29-44a9-9a84-097b420e0e7a000002"> </span></p></div></body></html>