Home and Community-based Services (HCS) Program Billing Guidelines

Appendix V
Determining Units of Service for the Supported Home Living Activity of Transporting an Individual

Revision 10-0; Effective October 1, 2009

Determining Units of Service for a Single Trip (Examples 1 and 2)

Example 1

Example 1 Facts

  • A program provider transports Individuals A, B and C, who are individuals receiving HCS supported home living, and Passenger D, a person enrolled in the program provider’s ICF/IID program, in the same vehicle, using one service provider.
  • Individual A departs at 8:15 a.m., Individual B departs at 8:25 a.m., and Individual C and Passenger D depart at 9:00 a.m.
  • Individuals A and B arrive at 9:15 a.m. Individual C and Passenger D arrive at 10:00 a.m.

Individual

Departure Time

Arrival Time

A

8:15

9:15

B

8:25

9:15

C

9:00

10:00

D

9:00

10:00

Example 1: Method A

Transportation time for Individuals A, B, and C is 105 minutes, with four passengers (A, B, C and D) and one service provider: The first individual (A) departed at 8:15 a.m. and the last individual (C) arrived at 10:00 a.m. The time between 8:15 and 10:00 is 105 minutes.

Passenger D does not need units of service determined because he is not enrolled in the HCS program. However, he is counted when determining the number of passengers.

The service time for individuals A, B, and C is 26.25 minutes:

Service Time = [# of Service Providers x Transportation Time] ÷ # of Passengers

  • Service Time = (1 x 105) ÷ 4
    Service Time = 105 ÷ 4
    Service Time = 26.25 minutes<

Using Appendix III, Conversion Table, the service time of 26.25 minutes is converted to 2 units of service.

Using Method A, Individuals A, B and C all have 2 units of service.

Example 1: Method B

Individual A’s transportation time has three segments:

  • transportation time of 10 minutes (8:15-8:25) with one passenger (A only) and one service provider;
  • transportation time of 35 minutes (8:25-9:00) with two passengers (A and B) and one service provider; and
  • transportation time of 15 minutes (9:00-9:15) with four passengers (A, B, C and D) and one service provider.

Individual B’s transportation time has two segments:

  • transportation time of 35 minutes (8:25-9:00) with two passengers (A and B) and one service provider; and
  • transportation time of 15 minutes (9:00-9:15) with four passengers (A, B, C and D) and one service provider.

Individual C’s transportation time has two segments:

  • transportation time of 15 minutes (9:00-9:15) with four passengers (A, B, C and D) and one service provider; and
  • transportation time of 45 minutes (9:15-10:00) with two passengers (C and D) and one service provider.

Passenger D does not need units of service determined because he is not enrolled in the HCS program. However, he is counted when determining the number of passengers.

Service Time = [# of Service Providers x Transportation Time] ÷ # of Passengers

Individual A’s service time for each segment:

  • Service Time = (1 x 10) ÷ 1
    Service Time = 10 ÷ 1
    Service Time = 10 minutes
  • Service Time = (1 x 35) ÷ 2
    Service Time = 35 ÷ 2
    Service Time = 17.5 minutes
  • Service Time = (1 x 15) ÷ 4
    Service Time = 15 ÷ 4
    Service Time = 3.75 minutes

Individual B’s service time for each segment:

  • Service Time = (1 x 35) ÷ 2
    Service Time = 35 ÷ 2
    Service Time = 17.5 minutes
  • Service Time = (1 x 15) ÷ 4
    Service Time = 15 ÷ 4
    Service Time = 3.75 minutes

Individual C’s service time for each segment:

  • Service Time = (1 x 15) ÷ 4
    Service Time = 15 ÷ 4
    Service Time = 3.75 minutes
  • Service Time = (1 x 45) ÷ 2
    Service Time = 45 ÷ 2
    Service Time = 22.5 minutes

Total service time for each individual is determined by adding the service time of each segment:

  • Individual A: 10 minutes + 17.5 minutes + 3.75 minutes = 31.25 minutes
  • Individual B: 17.5 minutes + 3.75 minutes = 21.25 minutes
  • Individual C: 3.75 minutes + 22.5 minutes = 26.25 minutes

Using Appendix III, Conversion Table, service time is converted to units of service:

  • Individual A: 31.25 minutes = 2 units of service
  • Individual B: 21.25 minutes = 1 unit of service
  • Individual C: 26.25 minutes = 2 units of service

Using Method B, Individual B has 1 unit of service, and Individuals A and C each have 2 units of service.

Example 2

Example 2 Facts

  • A program provider transports two individuals, Individuals E and F, in the same vehicle using two service providers.
  • Individual E departs with a service provider at 2:00 p.m. Individual F departs with another service provider at 2:10 p.m.
  • Individuals E and F arrive at 2:40 p.m.

Individual

Departure Time

Arrival Time

E

2:00

2:40

F

2:10

2:40

Example 2: Method A

The transportation time for Individuals E and F is 40 minutes, with two passengers (E and F) and two service providers. The first individual (E) departed at 2:00 and the last individuals (E and F) arrived at 2:40. The time between 2:00 and 2:40 is 40 minutes.

The service time for individuals E and F is 40 minutes:

Service Time = [# of Service Providers x Transportation Time] ÷ # of Passengers

  • Service Time = (2 x 40) ÷ 2
    Service Time = 80 ÷ 2
    Service Time = 40 minutes

Using Appendix III, Conversion Table, the service time of 40 minutes is converted to 3 units of service.

Using Method A, Individuals E and F each have 3 units of service of supported home living for the transportation provided.

Example 2: Method B

Individual E’s transportation time has two segments:

  • transportation time of 10 minutes (2:00-2:10) with one passengers (E only) and one service provider; and
  • transportation time is 30 minutes (2:10-2:40) with two passengers (E and F) and two service providers.

Individual F’s transportation time has one segment:

  • Transportation time is 30 minutes (2:10-2:40) with two passengers (E and F) and two service providers.

Service Time = [# of Service Providers x Transportation Time] ÷ # of Passengers

Individual E’s service time for each segment:

  • Service Time = (1 X 10) ÷ 1
    Service Time = 10 ÷ 1
    Service time = 10 minutes
  • Service Time = (2 X 30) ÷ 2
    Service Time = 60 ÷ 2
    Service Time = 30 minutes

Individual F’s service time:

  • Service Time = (2 X 30) ÷ 2
    Service Time = 60 ÷ 2
    Service Time = 30 minutes

Total service time for Individual E is determined by adding the service time of each segment:

  • Individual E: 10 minutes + 30 minutes = 40 minutes

Using Appendix III, Conversion Table, service time is converted to units of service:

  • Individual E: 40 minutes = 3 units of service
  • Individual F: 30 minutes = 2 units of service

Using Method B, Individual E has 3 units of service and Individual F has 2 units of service.

Determining Units of Service for Multiple Trips (Example 3)

Example 3

Example 3 Facts

  • A program provider transports Individuals A, B and C and Passenger D, as described in Example 1 (this will be referred to as the “outgoing trip”).
  • The program provider transports Individuals A, B and C and Passenger D back to their original locations later the same day (the “return trip”).
  • Service times for the return trip for Individuals A, B and C are the same as the service times for the outgoing trip.

Example 3: Method A Service Times (see Example 1: Method A)

Individual

Outgoing Trip
Service Time

Return Trip
Service Time

A

26.25

26.25

B

26.25

26.25

C

26.25

26.25

Example 3: Method A – Without Accumulation of Service Times

Service times for the outgoing and return trips for Individuals A, B and C are notaccumulated; units of service from the outgoing trip (see Example 1: Method A) are combined with the units of service of the return trip: 2 units of service + 2 units of service = 4 units of service.

Using Method A without accumulating service times for the outgoing and return trips, Individuals A, B and C each have 4 units of service.

Example 3: Method A – With Accumulation of Service Times

Service times of the outgoing and the return trips for Individuals A, B and C are accumulated for a total service time of 52.5 minutes: 26.25 minutes + 26.25 minutes = 52.5 minutes.

Using Appendix III, Conversion Table, the total service time of 52.5 minutes is converted to 3 units of service.

Using Method A and accumulating service times for the outgoing and return trips, Individuals A, B and C each have 3 units of service.

Example 3: Method B Service Times (see Example 1: Method B)

Individual

Outgoing Trip
Service Time

Return Trip
Service Time

A

31.25

31.25

B

21.25

21.25

C

26.25

26.25

Example 3: Method B – Without Accumulation of Service Times

Service times for the two trips are not accumulated; units of service from the outgoing trip (see Example 1: Method B) are combined with the units of service of the return trip:

  • Individual A: 2 units of service + 2 units of service = 4 units of service
  • Individual B: 1 unit of service + 1 unit of service = 2 units of service
  • Individual C: 2 units of service + 2 units of service = 4 units of service

Using Method B without accumulating service times for the outgoing and return trips, Individuals A and C each have 4 units of service; Individual B has 2 units of service.

Example 3: Method B – With Accumulation of Service Times

Service times of the outgoing and the return trips for Individuals A, B and C are accumulated for a total service time:

  • Individual A: 31.25 minutes + 31.25 minutes = 1 hour, 2.5 minutes
  • Individual B: 21.25 minutes + 21.25 minutes = 42.5 minutes
  • Individual C: 26.25 minutes + 26.25 minutes = 52.5 minutes

Using Appendix III, Conversion Table, the total service time is converted to units of service:

  • Individual A: 1 hour, 2.5 minutes = 4 units of service
  • Individual B: 42.5 minutes = 3 units of service
  • Individual C: 52.5 minutes = 3 units of service

Using Method B and accumulating service times for the outgoing and return trips, Individual A has 4 units of service, and Individuals B and C each have 3 units of service.