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Assisted Living Waiver Providers Eligible for Health Care Coordination Service Reimbursement

Posted Jun 3, 20211 min Read

Payment & Reimbursement

The Division of Aging (DA) has a health care coordination service on the Aged and Disabled Waiver that allows assisted living providers to perform for their assisted living residents.  These services are not reimbursed through the bundle of assisted living activities within the A&D Waiver. A waiver participant may receive up to 16 hours each month of health care coordination service. The DA’s expectation is that care managers place the full 16 hours on client service plans.  However, if the provider does not need all 16 hours, they would not bill for them.


Prior to a provider billing for health care coordination services, the assisted living facility must communicate with the resident’s waiver care manager that the resident would like to receive health care coordination.  Some facilities have created a consent form for residents to sign agreeing to health care coordination. The consent forms are emailed to the resident’s care manager upon the resident signing it. The assisted living provider will receive a Notice of Action with the health care coordination service.

About the Author

Elizabeth Eichorn