The Office of Long-Term Living (OLTL) issued a notice to announce a procedure code change for Cognitive Rehabilitation Therapy (CRT) Services within the OBRA Waiver. Due to 2020 Healthcare Common Procedure Coding System (HCPCS) updates, the procedure code for CRT in the OBRA Waiver is changing from 97127 SE (which was end-dated as of May 25, 2020) to 92507 SE (effective May 26, 2020).

The service definition and units of service will remain the same. OBRA Waiver Cognitive Rehabilitation Providers will be required to utilize “92507 SE” for claims submitted with dates of service 5/26/2020 forward for Cognitive Rehabilitation. The “OLTL Home and Community-Based Waiver Services Rates” sheet has been updated to reflect the change.

Another automated system update is scheduled to occur in HCSIS on 5/29/2020 to add the new “92507 SE” code so it is available for selection onto OBRA Waiver FY 2020-2021 service plans. Service Coordinators (SC) will need to manually add the new service code “92507 SE” onto OBRA Waiver FY 2020-2021 service plans. OLTL’s Participant Services Review Unit within the Division of Fee- For- Service (FFS) Operations will be working directly with impacted OBRA Waiver Service Coordination Entities (SCE) to address any additional FY 2020-2021 service plan updates.

Members that have billing questions regarding this procedure code change or wish to receive the new rates sheet in an alternate format should contact the OLTL Provider Inquiry Unit or 800-932-0939.