Day Services

(A) Conditions of Payment. Day services are covered for participants who need a structured day activity program and who are not interested in employment or not ready to join the general workforce. (B) Nonpayable Services. (1) Per diem day services will not be covered on the same day as community-based day supports, supported employment, or prevocational services are covered. However, partial per diem day services may be provided on the same day as community-based day supports, supported employment, or prevocational services. (2) Day services, community-based day supports, supported employment, and prevocational services, in combination, are limited to no more than 156 hours per month. Each day of day services is considered to be six hours. The MassHealth agency or its designee may grant individualized exceptions to the limit on a 30-day basis in order to maintain a participant’s tenure in the community, to facilitate transitions to a community setting, or to otherwise facilitate the participant’s successful engagement in community-based waiver services. Exceptions to the 156 hour per month limit must be included in the participant’s waiver plan of care. (C) Recordkeeping. In addition to the requirements of 130 CMR 630.441, the provider must maintain records that include detailed descriptions of day services provided and documentation of all units of services.