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Outpatient Services - Personal Care Services (PCS) Update to the BH Manual

Date: 05/16/24

Louisiana Healthcare Connections is sharing with providers an update to the Outpatient Services - Personal Care Services (PCS) update to the Behavioral Health Services Provider Manual.

  • Addition to the Service Utilization section inclued: 
    Services are limited to 20 hours per week. An exception may be made by the MCO Medical Director to exceed this limit with documentation that services are medically necessary and the member does not qualify for personal care services under another Medicaid-funded program.
    The weekly limit does not include the per diem rate, which is to be used for temporary, timelimited events in which a member may need additional assistance, such as following a member’s hospitalization. The per diem rate shall not exceed 30 non-consecutive calendar days in a one-year period.
  • Addition to the Billing section include:
    The per diem rate is to be used for temporary, time-limited events when the member needs additional assistance,such as following a member’s hospitalization. The per diem rate shall not exceed 30 non-consecutive calendar days in a one-year period;           
  • In addition to the updates posted, the removal of "non-consecutive" (calendar days) taken from the Service Utilization and Billing sections after the public comment period.

Providers are encouraged to review the entire Personal Care Services (PCS) update and the Behavioral Health Service Provider Manual for additional information.