Adult Day: Allowable Services

Posted on May 19, 2020 by Roni Falck

The U.S. Department of Veterans Affairs has amended service delivery for Adult Day Services in response to COVID -19. Allowable services, with the consent of the Veteran as allowed by state plan, include: 

• Personal care services provided in the home, and comparable to the amount of personal care services previously delivered in the adult day health care center.
• Skilled services by appropriately credentialed professionals provided in the home, telephonically, or via live virtual video conferencing.
• Meals and supplies delivered to a Veteran’s home at the level established by their care plan.
• Outreach over telephone to assess wellness and detect developing needs on days when a Veteran would normally attend the adult day health center.

Services can be provided concurrently, on the same day, on different days than the Veteran would normally attend the adult day health care center, or on more days than the Veteran would normally attend the center.

Centers can submit claims according to the active authorization under the following HCPCS code options:

• S 5101 (Half Day):  services listed in 1a and 1c
• S5102 or S5105 (Full Day):  services listed in any three of the lettered items in 1a through 1d

Each half or full day billing requirement can be met across multiple days. For example, if an adult day health care center and Veteran decide to have the 2 days per week of authorized services provided over more than 2 days per week, the center would submit a claim for 2 days per week.

We recommend connecting with your Veterans Affairs Medical Center for additional clarification. You may also contact Roni Falck (rfalck@leadingagemn.org) for assistance.