Crosswalk of State Codes and Long Term Community Supports

Service
Name/Description

Current
NCTracks/ Existing Alliance codes

Current Rate

JCB 408/417  State-Funded Crosswalk

JCB 408/417
Rates

Medicaid LTCS
Crosswalk

Medicaid LTCS
Rates Per Diem

Residential Supports

YM850

$96.25 per diem

Residential Supports Level 1

$94.74

LTCS Level 3

$184.25

Personal Assistance- Individual

YP020

 $5.00 per 15-minute unit regularly / $5.50 per 15
min unit for COVID rate

Community Living and Supports –
Individual

N/A

No LTCS level, crosswalk to CLS

N/A

Developmental Day (Inc. Before/After)

YP610

 $2.50 per 15-minute unit

Day Supports  Group

TBD

LTCS Level 1

$136.00

Day Activity

YP660

Provider specific per rate table

Day Supports – Group

No change

LTCS Level 1

$136.00

Group Living- Low

YP760

 $55.29 per diem regularly /$63.58
per diem Covid rate

Residential Supports Level 1

$94.74

LTCS Level 3

$184.25

Group Living- Moderate

YP770

 $75.48 per diem regularly / $86.80
per diem covid rate

Residential Supports Level 2

$135.86

LTCS Level 4

$222.20

Group Living- High

YP780

 $141.51 per diem regularly /
$162.74 covid rate

Residential Supports Level 3

$246.16

LTCS Level 5

$213.53

Supervised Living- Low

YP710

 $28.92 per diem regularly / $33.26
per diem covid rate

Residential Supports Level 1

$94.74

LTCS Level 3

$184.25

Supervised Living, 2 Resident

YM812

 $161.99 per diem

Residential Supports Level 3

$246.16

LTCS Level 5

$213.53

Supervised Living, 3 Resident

YM813

 $116.15 per diem

Residential Supports Level 2

$135.86

LTCS Level 4

$222.20

Supervised Living, 4 Resident

YM814

 $93.17 per diem

Residential Supports Level 1

$94.74

LTCS Level 5

$213.53

Supervised Living, 5 Resident

YM815

 $77.67 per diem

Residential Supports Level 1

$94.74

LTCS Level 3

$184.25

Supervised Living, 6 Resident

YM816

 $68.83 per diem

Residential Supports Level 1

$94.74

LTCS Level 3

$184.25

Developmental Therapy – Paraprofessional

H2014 UM (code in JCB) / H2014 HM (code
in Alliance benefit plan)

 $6.61 per 15-minute unit / $7.60
per 15-minute unit- COVID rate

Community Living and Supports –
Individual

No LTCS level, will crosswalk to CLS 16+

N/A

Developmental Therapy – Professional-
Adult

H2014 (code in JCB) / H2014 HB (Code in
Alliance benefit plan for Professional – Adult)

$8.34 per 15-minute unit

Community Living and Supports –
Individual

$6.61 per 15-minute unit / $7.60 per
15-minute unit- COVID rate

No LTCS level, will crosswalk to CLS
group

N/A

Developmental Therapy – Professional-
Child

H2014 (code in JCB) / H2014 HA (Code in
Alliance benefit plan for Professional – Child)

 $8.34 per 15-minute unit

Community Living and Supports –
Individual

$6.61 per 15-minute unit / $7.60 per
15-minute unit- COVID rate

No LTCS level, will crosswalk to CLS
group

N/A

Personal Care

YM050

N/A

not on benefit plan

N/A

not on benefit plan

N/A

Family Living Low

YM740

N/A

not on benefit plan

N/A

not on benefit plan

N/A

Family Living Moderate

YP750

N/A

not on benefit plan

N/A

not on benefit plan

N/A

Family Living High

YM755

N/A

not on benefit plan

N/A

not on benefit plan

N/A

Supervised Living Moderate

YP720

N/A

not on benefit plan

N/A

not on benefit plan

N/A

Developmental Therapy – Paraprofessional
Group

H2014 U1 (code in JCB) / This code is
not in Alliance’s benefit plan (only 1 Paraprofessional DT code in Alliance
benefit plan

N/A

not on benefit plan

N/A

not on benefit plan

N/A

Supervised Living, 1 Resident

YM811

N/A

not on benefit plan

N/A

not on benefit plan

N/A