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evision 20-4; Effective October 9, 2020
For a service that has a billable unit of one hour, a provider agency must determine the billable units using the amount of time that a service provider spent providing the service in accordance with the table below.
| Service Time | Billable Unit(s) of Service |
|---|---|
| Less than 8 minutes | 0.00 |
| At least 8 minutes, but less than 23 minutes | 0.25 |
| At least 23 minutes, but less than 38 minutes | 0.50 |
| At least 38 minutes, but less than 53 minutes | 0.75 |
| At least 53 minutes, but less than 1 hour 8 minutes | 1.00 |
| At least 1 hour 8 minutes, but less than 1 hour 23 minutes | 1.25 |
| At least 1 hour 23 minutes, but less than 1 hour 38 minutes | 1.50 |
| At least 1 hour 38 minutes, but less than 1 hour 53 minutes | 1.75 |
| At least 1 hour 53 minutes, but less than 2 hours 8 minutes | 2.00 |
| At least 2 hours 8 minutes, but less than 2 hours 23 minutes | 2.25 |
| At least 2 hours 23 minutes, but less than 2 hours 38 minutes | 2.50 |
| At least 2 hours 38 minutes, but less than 2 hours 53 minutes | 2.75 |
| At least 2 hours 53 minutes, but less than 3 hours 8 minutes | 3.00 |
| At least 3 hours 8 minutes, but less than 3 hours 23 minutes | 3.25 |
| At least 3 hours 23 minutes, but less than 3 hours 38 minutes | 3.50 |
| At least 3 hours 38 minutes, but less than 3 hours 53 minutes | 3.75 |
| At least 3 hours 53 minutes, but less than 4 hours 8 minutes | 4.00 |
| At least 4 hours 8 minutes, but less than 4 hours 23 minutes | 4.25 |
| At least 4 hours 23 minutes, but less than 4 hours 38 minutes | 4.50 |
| At least 4 hours 38 minutes, but less than 4 hours 53 minutes | 4.75 |
| At least 4 hours 53 minutes, but less than 5 hours 8 minutes | 5.00 |
| At least 5 hours 8 minutes, but less than 5 hours 23 minutes | 5.25 |
| At least 5 hours 23 minutes, but less than 5 hours 38 minutes | 5.50 |
| At least 5 hours 38 minutes, but less than 5 hours 53 minutes | 5.75 |
| At least 5 hours 53 minutes, but less than 6 hours 8 minutes | 6.00 |
| At least 6 hours 8 minutes, but less than 6 hours 23 minutes | 6.25 |
| At least 6 hours 23 minutes, but less than 6 hours 38 minutes | 6.50 |
| At least 6 hours 38 minutes, but less than 6 hours 53 minutes | 6.75 |
| At least 6 hours 53 minutes, but less than 7 hours 8 minutes | 7.00 |
| At least 7 hours 8 minutes, but less than 7 hours 23 minutes | 7.25 |
| At least 7 hours 23 minutes, but less than 7 hours 38 minutes | 7.50 |
| At least 7 hours 38 minutes, but less than 7 hours 53 minutes | 7.75 |
| At least 7 hours 53 minutes, but less than 8 hours 8 minutes | 8.00 |
| At least 8 hours 8 minutes, but less than 8 hours 23 minutes | 8.25 |
| At least 8 hours 23 minutes, but less than 8 hours 38 minutes | 8.50 |
| At least 8 hours 38 minutes, but less than 8 hours 53 minutes | 8.75 |
| At least 8 hours 53 minutes, but less than 9 hours 8 minutes | 9.00 |
| At least 9 hours 8 minutes, but less than 9 hours 23 minutes | 9.25 |
| At least 9 hours 23 minutes, but less than 9 hours 38 minutes | 9.50 |
| At least 9 hours 38 minutes, but less than 9 hours 53 minutes | 9.75 |
| At least 9 hours 53 minutes, but less than 10 hours 8 minutes | 10.00 |
| At least 10 hours 8 minutes, but less than 10 hours 23 minutes | 10.25 |
| At least 10 hours 23 minutes, but less than 10 hours 38 minutes | 10.50 |
| At least 10 hours 38 minutes, but less than 10 hours 53 minutes | 10.75 |
| At least 10 hours 53 minutes, but less than 11 hours 8 minutes | 11.00 |
| At least 11 hours 8 minutes, but less than 11 hours 23 minutes | 11.25 |
| At least 11 hours 23 minutes, but less than 11 hours 38 minutes | 11.50 |
| At least 11 hours 38 minutes, but less than 11 hours 53 minutes | 11.75 |
| At least 11 hours 53 minutes, but less than 12 hours 8 minutes | 12.00 |
| At least 12 hours 8 minutes, but less than 12 hours 23 minutes | 12.25 |
| At least 12 hours 23 minutes, but less than 12 hours 38 minutes | 12.50 |
| At least 12 hours 38 minutes, but less than 12 hours 53 minutes | 12.75 |
| At least 12 hours 53 minutes, but less than 13 hours 8 minutes | 13.00 |
| At least 13 hours 8 minutes, but less than 13 hours 23 minutes | 13.25 |
| At least 13 hours 23 minutes, but less than 13 hours 38 minutes | 13.50 |
| At least 13 hours 38 minutes, but less than 13 hours 53 minutes | 13.75 |
| At least 13 hours 53 minutes, but less than 14 hours 8 minutes | 14.00 |
| At least 14 hours 8 minutes, but less than 14 hours 23 minutes | 14.25 |
| At least 14 hours 23 minutes, but less than 14 hours 38 minutes | 14.50 |
| At least 14 hours 38 minutes, but less than 14 hours 53 minutes | 14.75 |
| At least 14 hours 53 minutes, but less than 15 hours 8 minutes | 15.00 |
| At least 15 hours 8 minutes, but less than 15 hours 23 minutes | 15.25 |
| At least 15 hours 23 minutes, but less than 15 hours 38 minutes | 15.50 |
| At least 15 hours 38 minutes, but less than 15 hours 53 minutes | 15.75 |
| At least 15 hours 53 minutes, but less than 16 hours 8 minutes | 16.00 |
| At least 16 hours 8 minutes, but less than 16 hours 23 minutes | 16.25 |
| At least 16 hours 23 minutes, but less than 16 hours 38 minutes | 16.50 |
| At least 16 hours 38 minutes, but less than 16 hours 53 minutes | 16.75 |
| At least 16 hours 53 minutes, but less than 17 hours 8 minutes | 17.00 |
| At least 17 hours 8 minutes, but less than 17 hours 23 minutes | 17.25 |
| At least 17 hours 23 minutes, but less than 17 hours 38 minutes | 17.50 |
| At least 17 hours 38 minutes, but less than 17 hours 53 minutes | 17.75 |
| At least 17 hours 53 minutes, but less than 18 hours 8 minutes | 18.00 |
| At least 18 hours 8 minutes, but less than 18 hours 23 minutes | 18.25 |
| At least 18 hours 23 minutes, but less than 18 hours 38 minutes | 18.50 |
| At least 18 hours 38 minutes, but less than 18 hours 53 minutes | 18.75 |
| At least 18 hours 53 minutes, but less than 19 hours 8 minutes | 19.00 |
| At least 19 hours 8 minutes, but less than 19 hours 23 minutes | 19.25 |
| At least 19 hours 23 minutes, but less than 19 hours 38 minutes | 19.50 |
| At least 19 hours 38 minutes, but less than 19 hours 53 minutes | 19.75 |
| At least 19 hours 53 minutes, but less than 20 hours 8 minutes | 20.00 |
| At least 20 hours 8 minutes, but less than 20 hours 23 minutes | 20.25 |
| At least 20 hours 23 minutes, but less than 20 hours 38 minutes | 20.50 |
| At least 20 hours 38 minutes, but less than 20 hours 53 minutes | 20.75 |
| At least 20 hours 53 minutes, but less than 21 hours 8 minutes | 21.00 |
| At least 21 hours 8 minutes, but less than 21 hours 23 minutes | 21.25 |
| At least 21 hours 23 minutes, but less than 21 hours 38 minutes | 21.50 |
| At least 21 hours 38 minutes, but less than 21 hours 53 minutes | 21.75 |
| At least 21 hours 53 minutes, but less than 22 hours 8 minutes | 22.00 |
| At least 22 hours 8 minutes, but less than 22 hours 23 minutes | 22.25 |
| At least 22 hours 23 minutes, but less than 22 hours 38 minutes | 22.50 |
| At least 22 hours 38 minutes, but less than 22 hours 53 minutes | 22.75 |
| At least 22 hours 53 minutes, but less than 23 hours 8 minutes | 23.00 |
| At least 23 hours 8 minutes, but less than 23 hours 23 minutes | 23.25 |
| At least 23 hours 23 minutes, but less than 23 hours 38 minutes | 23.50 |
| At least 23 hours 38 minutes, but less than 23 hours 53 minutes | 23.75 |
| At least 23 hours 53 minutes, but less than 24 hours 8 minutes | 24.00 |
7601 Determining Billable Units for Multiple Service Events
Revision 20-4; Effective October 9, 2020
For a service with a billable unit of one hour, if there is more than one service event of the same service in a calendar month, a program provider must determine total billable units for the month by determining the billable units for each service event and adding the billable units together.
Example:
| Service Provider | Time Service Begins | Time Service Ends | Duration of Service Event | Billable Units |
|---|---|---|---|---|
| Service Provider A | 8:00 a.m. | 4:05 p.m. | 8 hours 5 minutes | 8.00 |
| Service Provider B | 4:45 p.m. | 6:07 p.m. | 1 hour 22 minutes | 1.25 |
| Service Provider B | 8:50 p.m. | 11:01 p.m. | 2 hours 11 minutes | 2.25 |
| Total Billable Units | 11.50 | |||
7610 Billing Units of Respite Service
Revision 11-1; Effective June 13, 2011
Partial units of respite are calculated as follows:
| Service Time | Unit of Service |
|---|---|
| 1 hour of service | = 1/24 unit (.04) |
| 2 hours of service | = 2/24 unit (.08) |
| 3 hours of service | = 3/24 unit (.12) |
| 4 hours of service | = 4/24 unit (.17) |
| 5 hours of service | = 5/24 unit (.21) |
| 6 hours of service | = 6/24 unit (.25) |
| 7 hours of service | = 7/24 unit (.29) |
| 8 hours of service | = 8/24 unit (.33) |
| 9 hours of service | = 9/24 unit (.37) |
| 10 hours of service | = 10/24 unit (.42) |
| 11 hours of service | = 11/24 unit (.46) |
| 12 hours of service | = 12/24 unit (.50) |
| 13 hours of service | = 13/24 unit (.54) |
| 14 hours of service | = 14/24 unit (.58) |
| 15 hours of service | = 15/24 unit (.62) |
| 16 hours of service | = 16/24 unit (.67) |
| 17 hours of service | = 17/24 unit (.71) |
| 18 hours of service | = 18/24 unit (.75) |
| 19 hours of service | = 19/24 unit (.79) |
| 20 hours of service | = 20/24 unit (.83) |
| 21 hours of service | = 21/24 unit (.87) |
| 22 hours of service | = 22/24 unit (.92) |
| 23 hours of service | = 23/24 unit (.96) |
| 24 hours of service | = 24/24 unit (1.0) |
7620 Billing Units of Out-of-Home Respite Service
Revision 11-1; Effective June 13, 2011
The DSA must use the following procedure to bill as closely as possible to the actual cost for out-of-home respite services delivered. To calculate the units of respite that the DSA would bill for, the provider needs to calculate to the nearest partial unit the amount that allows adequate reimbursement to cover the actual cost of the service based on the current out-of-home respite rate per 24-hour period. This is done by dividing the total actual cost for respite by the current daily rate.
Administrative costs to the DSA related to arranging for respite services cannot be included in this billing calculation but should be reported on the DSA's cost report.