Appendix III, LTSS Billing Matrix and Crosswalk

Effective June 2022

See the new LTSS Billing Matrix and Crosswalk (Excel) effective Dec. 1, 2022. This matrix must be used for services provided on or after Dec. 1, 2022.

The LTSS Billing Matrix and Crosswalk is a table that provides the billing codes and modifiers for State Plan services utilized in STAR Kids as well as services specific to the Medically Dependent Children Program (MDCP).

MCOs and providers must use the link below for services provided on or before Nov. 30, 2022.

Appendix III, LTSS Billing Matrix and Crosswalk (Excel)

Appears In

  • STAR Kids Handbook
  • STAR Kids Program Support Unit Operational Procedures Handbook