Issued: April 22, 2020
On April 16, 2020, Partners released Provider Alert COVID-19 #18 – Appendix K Retainer Payment Requests, outlining the requirements and process for Appendix K retainer payments. Partners is modifying the process providers need to follow to submit Appendix K retainer payments. Effective April 22, 2020:
1. When the waiver participant/primary caregiver or the hired employee notifies the provider that the hired employee cannot provide care, a retainer payment agreement may be initiated for a 30-day period or until such a time that the staff has returned to work.
2. Starting April 22, 2020, providers will need to submit claims into the AlphaMCS system using the codes with the appropriate CR and XU Modifier below:
|SERVICE CODE||INNOVATIONS SERVICE|
|H2015 CR XU||Community Networking Service (Individual)|
|H2015 HQ CR XU||Community Networking Group|
|H2016 CR XU||Residential Supports: Level 1|
|H2016 U2 CR XU||Residential Supports: Level 1 AFL|
|H2016 HI CR XU||Residential Supports: Level 4|
|H2016 HI U2 CR XU||Residential Supports: Level 4 AFL|
|H2025 CR XU||Supported Employment Services Individual|
|H2025 HQ CR XU||Supported Employment Services Group|
|H2025 TS CR XU||Supported Employment LTFU – Individual|
|H2025 TS HQ CR XU||Supported Employment LTFU – Group|
|H2025 U2 CR XU||Supported Employment|
|T2013 TF CR XU||Community Living & Supports – Individual|
|T2013 TF HQ CR XU||Community Living & Supports Group|
|T2014 CR XU||Residential Supports: Level 2|
|T2014 U2 CR XU||Residential Supports: Level 2 AFL|
|T2020 CR XU||Residential Supports: Level 3|
|T2020 U2 CR XU||Residential Supports: Level 3 AFL|
|T2021 CR XU||Day Supports: Individual|
|T2021 HQ CR XU||Day Supports: Group|
|T2027 CR XU||Day Supports: Developmental Day|
|T2033 CR XU||Supported Living – Living 1|
|T2033 HI CR XU||Supported Living – Living 2|
|T2033 TF CR XU||Supported Living – Living 3|
|T2033 U1 CR XU||Supported Living Periodic|
3. Provider agencies and EOR(s) will continue to submit information to Partners every Monday for the previous week, using the updated form available at https://providers.partnersbhm.org/covid-19-provider-forms/. Providers will now email the completed form to email@example.com.
4. As a reminder, provider agencies and EOR(s) shall maintain documentation via the required service grid by entering COVID-19 on the grid with the Qualified Professional’s signature/EOR signature and date.
5. Retainer Payments shall be effective beginning March 13, 2020 and will end when the member is again available for services following the COVID-19 emergency. Invoices submitted through April 21, 2020 will be paid based on the Invoice already submitted. However, all Retainer Payments submitted April 22, 2020 forward, will be paid by claims in the AlphaMCS system.
If you have any questions regarding Appendix K Retainer Payment Requests, please e-mail firstname.lastname@example.org. For questions regarding other flexibilities in Appendix K, please submit questions regarding other flexibilities in Appendix K to InnovationsExceptions@partnersbhm.org.