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ModifiedExecutive Office of Health and Human ServicesPolicy N/A

Personal Assistance Services and Supports (PASS) practice standards

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Requirements and practice standards for providers delivering Personal Assistance Services and Supports (PASS) to Medicaid-eligible children and adolescents in Rhode Island, including eligibility, prior approval, clinical criteria, service planning, and provider responsibilities.

Policy Summary

PayerExecutive Office of Health and Human Services

PolicyPersonal Assistance Services and Supports (PASS) practice standards

Policy CodePolicy N/A

Change TypeModified — operational and clinical updates

Effective DateJul 1, 2016

Last ReviewFeb 1, 2004

Next Review DateN/A

Key ActionSubmit prior authorization for PASS services (children under 6 require EOHHS/third‑party authorization 30 days before initiation).

SourceLink

POLICY UPDATE CHANGES

PASS Agency responsibility to assess current clinical needs of the child and family to determine treatment intensity.

PASS requests for children younger than 6 require EOHHS/third party payer authorization 30 days prior to initiation or continuation.

Maximum of 6 PASS hours per day unless otherwise clinically justified.

PASS Service Plans are approved for 12 months with required 6 month progress reports.

Clinical Consultation (T1027) frequency increased to 2 hours monthly with potential for additional hours case-by-case.

PASS treatment hours per week must be substantiated with medical necessity and measurable goals: up to 20 hours for PASS alone; up to 25 hours combined with HBTS when documented.

6max PASS per day

12 moService Plan duration

2 hrs/moClinical consultation min

20Max PASS hrs/week

25Max PASS+HBTS/week

Coverage Criteria and Clinical Eligibility

Initial Service Plan Approval

Covered when ALL of the following are met

Federal and program eligibility: Recipient is Medicaid-eligible (birth to 21) and meets the Federal definition of disability; eligible through SSI, Katie Beckett, Adoption Subsidy, Rite Care, or Rite Share; child lives at home with consenting legal guardian or is over 18 and consents to services.

See eligibility requirements.

Clinical Eligibility

AND the following clinical conditions must be documented

Clinical documentation: A formal behavioral health or medical diagnosis by a qualified licensed health care professional within the past 3 years, including at minimum a clinical diagnostic interview and evidence of functional impairment; neuropsychological/psychological/educational testing and/or language evaluation when indicated; and family/caregiver willingness to accept and cooperate with PASS as specified in the Service Plan.

Provider agencies shall work with families and third-party payers to obtain necessary evaluations.

Policy Summary

PayerExecutive Office of Health and Human Services

PolicyPersonal Assistance Services and Supports (PASS) practice standards

Policy CodePolicy N/A

Change TypeModified — operational and clinical updates

Effective DateJul 1, 2016

Last ReviewFeb 1, 2004

Next Review DateN/A

Key ActionSubmit prior authorization for PASS services (children under 6 require EOHHS/third‑party authorization 30 days before initiation).

SourceLink

On This Page

Assessment and Service Plan Development

Assessment and Service Plan must meet ALL of the following:

Assessment and Service Plan Development: Assessment and Service Plan development must be completed under the supervision of a qualified RI-licensed health care professional; the PASS Agency coordinator must assess family readiness and work with the family to design the Service Plan; a minimum of one home visit to assess health and safety must occur prior to submission/authorization; the PASS Agency Clinical Consultant must assist in writing, review and sign the Service Plan; Service Plans are authorized for 12 months and renewable annually; back-up plans for Direct Service Worker absence must be included.

Service Plan renewal requires reassessment of progress toward goals and agreement of all parties.

Treatment Intensity (Hours per Week)

Treatment intensity (hours/week) covered when ALL of the following are documented:

Treatment Intensity Factors: PASS treatment hours per week must be substantiated by documented medical necessity and measurable goals specifying frequency and duration of each service; determination must consider child's age; ability to engage in sustained treatment; type, nature, and course of condition; severity of behaviors; other treatment/educational services received; impact on family functioning; co-existing conditions; biological/neurological abnormalities; current functional capacities; family factors; and interaction with other agencies or providers.<= 20 hours/week

PASS Agency is responsible for determining appropriate intensity up to 20 hours/week; combined PASS+HBTS up to 25 hours when documented.

PASS coverage and medical necessity

Covered when services meet medical necessity and program intent

PASS coverage conditions: Services support at least one core PASS domain (activities of daily living, making self-preserving decisions, or participation in social/community settings) and are intended to enhance independence, social integration, and facilitate transition when applicable; PASS is designed to complement existing therapeutic services or serve as a step-down/alternative when indicated, not to replace licensed mental health, nursing, school-based, or respite services.

PASS will not be used for respite/childcare or to substitute for licensed clinician services or private duty nursing.

Medical necessity determination: A physician or other medical service provider's prescription or recommendation is required for determination of medical necessity, but the Medical Assistance Program makes the final determination; services must be provided in the most cost-effective, efficient and appropriate manner and not solely for convenience.

See Appendix 1 definition of Medical Necessity.

Staff qualifications and training for service provision

Covered when ALL of the following staffing and training requirements are met:

Staffing qualifications and training: 1) PASS Agency Coordinator: minimum high school diploma or equivalent plus 2 years college in human services or related field, demonstrated competency with families of children with special health care needs, and minimum one year experience with a similar population; 2) Clinical Consultant: licensed RI health care professional (LICSW, LCSW, RN with Master's, Psychologist, PT, OT, SLP, LMHC, LMFT, BCBA) with minimum two years' relevant experience; 3) Direct Service Worker: at least 18 years old, high-school diploma or equivalent, competent in child-specific tasks, not residing in the child's household; 4) All staff must receive agency orientation and role-specific training with personnel files documenting completed orientation; 5) Agency and child-specific training for Direct Service Workers (including CPR/First Aid for children/young adults, client rights, reporting, payroll/tax) must be completed prior to initiation of Direct Services and documented with family sign-off on Job Description/Contractual Agreement.

Agency must maintain written training plans and annual training schedules; Direct Services begin after Assessment/Service Plan completion and prior authorization approval.

Operational and approval criteria

PASS Agencies must meet the following performance and approval criteria:

Timeliness for new referrals: 1) Offer first meeting within 14 calendar days of referral; 2) Complete assessment and Service Plan within 30 calendar days of the first meeting; 3) Initiate direct services within 30 calendar days of signing the Service Plan; 4) Complete 100% of Service Plans requiring renewal at least 15 calendar days prior to expiration.as stated

From Timeliness Standards for New Referrals.

Provider application and approval: Applicants are evaluated on written materials; review process may take a minimum of two months and include on-site inspections; favorable determination results in a Letter of Approval; initial period of approval lasts 3 years from issuance.as stated

See Submission of Application and Period of Approval.

EOHHS enforcement actions: EOHHS may inspect records and sites, require corrective action, suspend new referrals up to 6 months, require recoupment of funds, institute Provisional Approval after 121 days of continued non-compliance (triggering 90 days of intensified oversight), and may revoke approval for inability to cure deficiencies or violations.as stated

Consequences and oversight measures described in EOHHS Oversight and Authorization.

Service Codes, Units, and Billing Rules

Referenced HCPCS/T codes in PASS practice standardsHCPCS

T1027	Clinical Consultation (2 hours monthly minimum)
T1013U1	Interpretation code for PASS clinical consultations (may be used up to 2 hours monthly)
H2016	Direct Implementation (billing contingent on identification of Direct Service Worker)

Covered PASS service codesHCPCSCovered

T1023-U1	Assessment and Service Plan Development
T1019	Direct service reimbursement (three rates by worker education/experience)
H2016	Direct Implementation
T1027	Clinical Consultation
T1013U1	Interpretation

Clinical consultation and weekly treatment hours

Clinical consultation frequencyClinical consultation (T1027): 2 hours per month

Maximum PASS weekly hoursUp to 20 hours per week (must be substantiated with medical necessity and measurable goals)

Maximum combined PASS+HBTS weekly hoursUp to 25 hours per week when PASS is combined with HBTS (must be documented and justified)

Session length and consultation limits

Billing unitUnit = 15 minutes per session for Direct Services

Consultation/Interpretation monthly limitClinical Consultation (T1027) and Interpretation (T1013U1): up to 2 hours per month

Unitization for claimsAll claims must be submitted within 12 months of date of service and reflect 15-minute units

Provider Responsibilities, Authorizations, and Operational Rules

Prior Authorization

Obtain prior authorization; weekly batch submissions for FFS

PASS requires prior approval for Medicaid-eligible clients. For fee-for-service families, prior authorizations using a batch form must be sent once a week to EOHHS prior to the start date of service; managed care enrollees follow third‑party payer procedures. Provider agencies must obtain referral information to screen and determine clinical eligibility before requesting prior authorization.

Batch prior authorizations: submit once weekly to EOHHS for FFS families, prior to service start date.
Follow managed care payer procedures for MCO-enrolled members.
Conduct initial screening and clinical eligibility determination before requesting authorization.

Prior Authorization

30‑day prior authorization required for children under age 6

Any PASS request for a child younger than six years requires authorization from EOHHS or the third‑party payer at least 30 days prior to initiation or continuation of services.

Do not start or continue PASS for children <6 without EOHHS/third‑party payer approval obtained ≥30 days in advance.

Billing Rule

Authorize specific PASS procedure codes before billing

Designated procedure codes for PASS service components must be authorized before billing. Assessment/Service Plan Development and specified PASS components use HCPCS/T codes (examples include T1023‑U1, T1019, H2016, T1027, and T1013U1) and units/hours vary by code.

T1023‑U1 for Assessment and Service Plan Development must be authorized.
Direct service codes (e.g., T1019), Direct Implementation (H2016), Clinical Consultation (T1027) and Interpretation (T1013U1) require authorization and follow the policy's units/limits.

Prior Authorization

Document provider prescription/recommendation for medical necessity

A physician or other medical service provider must prescribe or recommend services to support a medical necessity determination; however, the Medical Assistance Program makes the final determination of medical necessity.

Obtain and include the prescribing/recommending clinician's documentation when requesting authorization; EOHHS makes the final medical necessity decision.

Prior Authorization

Complete agency and child‑specific training before Direct Services start

Agency and child‑specific training for Direct Service Workers must be completed prior to initiation of Direct Services; family sign‑off on the Job Description/Contractual Agreement documents readiness and competency. After Assessment/Service Plan completion and prior authorization approval, Direct Services may begin and agencies may bill for Service Plan Implementation.

Provide agency orientation and role‑specific training; document in personnel files.
Complete child‑specific training and obtain family certification of worker readiness before starting services.
Begin billing for Service Plan Implementation only after Assessment/Service Plan completion and approved prior authorization.

Prior Authorization

Ensure Service Plan approval and meet timeliness milestones

Service Plans must be completed, approved, and time‑bound: offer first meeting within 14 days, complete assessment and Service Plan within 30 days of that meeting, and initiate direct services within 30 days of signing the Service Plan. Reauthorizations must be completed at least 15 days prior to plan expiration. Administrative hearings can alter prior authorization.

First meeting: within 14 calendar days of referral.
Assessment and Service Plan: complete within 30 calendar days of first meeting.
Initiate services: within 30 calendar days of signing the Service Plan.
Reauthorization: complete ≥15 days prior to plan expiration.
Be aware that Administrative Fair Hearing outcomes may adjust prior authorization.

Note

Meet 30‑day timelines for assessment, plan completion, and service start

Complete an assessment and Service Plan within 30 calendar days of the first meeting and initiate direct services within 30 calendar days of signing the Service Plan.

Track and document dates to demonstrate compliance with 30‑day assessment/plan and 30‑day service initiation requirements.

Note

Anticipate ≈2 months for provider application review (may include site visit)

Provider applicants should expect a minimum two‑month review period for approval; reviews may include on‑site inspections and requests for additional clarification before issuing a Letter of Approval.

Prepare required written materials and be available for possible site inspections and follow‑up requests during the ~2‑month review.

Note

Perform intake screening, document eligibility, and support orderly transfers

Conduct initial screening and determine clinical eligibility before enrollment; families may choose a PASS Agency or use their HBTS/PASS Agency. When transferring, the current PASS Agency must assist in an orderly transfer with coordination and written documentation.

Document intake screening results and eligibility determination.
Maintain written coordination records when assisting family transfers between agencies.

Step Therapy

Substantiate and document treatment intensity (hours/week)

Treatment intensity (direct service hours/week) must be justified by documented medical necessity and measurable goals; PASS Agencies determine appropriate intensity up to 20 hours/week (up to 25 hours/week when combined with HBTS and documented).

Support requested hours with measurable goals, frequency/duration, and multidisciplinary collaboration.
Maximums: up to 20 hours/week for PASS alone; up to 25 hours/week combined with HBTS when documented.

Note

Screen for eligibility, home safety, and family readiness at intake

Before initiating services, intake protocols must assess stability of the child's condition, home safety, and the family's willingness and capacity to assume consumer‑directed responsibilities; applicants must provide alternative recommendations when families are not eligible.

Document assessments of condition stability, home safety, and family readiness in the intake record.
Provide and record alternative recommendations if PASS is not appropriate.

Note

Document eligibility determinations and offer alternatives when ineligible

Intake must determine eligibility and admission criteria (stability, home safety, family willingness) and, if not eligible, provide alternative recommendations to families.

Maintain written intake protocols and document determinations and alternatives offered.

Note

Comply with EOHHS program modifications and service limits

EOHHS may amend program requirements with reasonable notice and may limit amount, duration, and scope of services when not medically necessary or unsafe; providers must comply with any such modifications.

Monitor EOHHS notices for program changes and update agency policies and Service Plans accordingly.

Documentation Required

Submit recent formal diagnosis and measurable goals for Service Plan approval

Service Plan approval requires documentation of a formal behavioral health or medical diagnosis made within the prior three years by a qualified licensed provider, demonstration of disability with functional impairment, and that goals are measurable with documented progress.

Include a formal diagnosis (≤3 years), standardized assessments as needed, and measurable goals in the Service Plan submission.

Documentation Required

Provide standardized assessments and reassessments for reauthorization

Clinical documentation for reauthorization must demonstrate ongoing disability with functional impairment using a standardized tool (e.g., Vineland), document progress toward goals, and include the Clinical Consultant's reassessment and summary at plan conclusion.

Provide standardized assessment results (such as Vineland) and measurable progress data at renewal.
Clinical Consultant must document and summarize the child's and family's response over the 12‑month Service Plan period.

Denial Risk

Provide written notification and inform families of appeal rights for suspensions/terminations

The PASS Agency must notify the family in writing of all instances or circumstances that affect temporary suspension or termination of services; families have the right to appeal to EOHHS.

Provide written notice to families for suspensions/terminations and inform them of appeal rights.

Documentation Required

Maintain orientation, training, and client records to substantiate billing

Personnel files must document completed agency orientation and training; client records must substantiate all billed services and include assessment, Service Plan goals, documentation of services and status changes, and informed consent where required.

Keep orientation/training records in staff personnel files.
Ensure client records support every billed unit and contain required assessment, plan, progress, and consent documentation.

Documentation Required

Include written policies/procedures for intake, assessment, and documentation in applications

Applications for approval must include written policies and procedures addressing intake, assessment and Service Plan development, documentation procedures for clinical consultation, and Service Plan modification processes.

Submit documented policies/procedures for assessment, plan development, clinical consultation, and recordkeeping with the application.

Documentation Required

Provide family information, grievance processes, and obtain signed consent/acknowledgment

Provide informational materials and grievance/appeal processes to families at onset and annually; the Service Plan must include a signed family statement affirming understanding of rights and responsibilities, and families may terminate or suspend PASS as desired.

Give families written materials on PASS services, grievance/appeal processes, and obtain signed acknowledgment of understanding.
Re‑provide materials annually and document family signatures.

Billing Rule

Record weekly direct service hours and obtain co‑signed timesheets to support billing

Record and submit systematic weekly documentation of PASS direct service hours; Direct Service Worker timesheets must be co‑signed weekly by the designated family supervisor. Services billed must correspond to approved Service Plan hours and be supported by written documentation.

Maintain weekly co‑signed timesheets and supporting documentation that match billed units.
Ensure claims are within the Service Plan's approved hours.

Note

Conduct parent satisfaction surveys at plan completion and report annually

Parent satisfaction surveys must be conducted at the completion of each authorized Service Plan and reported to EOHHS annually (reported to EOHHS by April 1); surveys should include quantitative and qualitative feedback on family‑centeredness, clinical consultation availability, progress, communication, and staff performance.

Conduct surveys at plan completion; analyze results and submit annual report to EOHHS by April 1.
Include measures of family centeredness, clinical consultation utilization, progress, communication, and staff availability.

Denial Risk

Verify Medicaid coverage; risk of nonpayment and retroactive reimbursement conditions

Verify continuous Medicaid coverage before providing services; loss of Medicaid eligibility may result in nonpayment. Providers may request retroactive reimbursement once coverage has resumed only if there has been no lapse in Medicaid coverage and the child has an approved PASS Service Plan.

Confirm enrollment via the RI provider portal and document verification in the record.
If coverage issues arise, follow retroactive reimbursement rules: no lapse in coverage and an approved PASS Service Plan are required.

Denial Risk

Non‑participation in renewal, loss of eligibility, or higher‑level care may trigger suspension

Failure of a family to participate in the renewal process, loss of Medicaid eligibility, or admission to a residential program/hospital can result in suspension of services; agencies must document attempts to engage the family.

Document family outreach and renewal attempts; lack of participation can trigger suspension.
Record changes in eligibility or higher‑level care admissions and act per discontinuation procedures.

Denial Risk

Recognize and document triggers that justify suspension or termination of services

Services may be suspended or terminated for loss of Medicaid eligibility; risk of harm to self/others or need for a more intensive level of care; safety risks in the home to staff (threats, substance use, firearms, contagious illness); failure to follow agency program rules despite documented attempts; or admission to a residential program or hospital.

Provide written notice to families for suspension/termination and document the specific trigger and supporting evidence.

Note

Document reasons when declining to write a Service Plan; repeated refusal risks agency review

PASS Agencies may decline to write a Service Plan when PASS is unsuitable due to health/safety concerns, family unwillingness/incapacity, or clinician documentation that the child does not require PASS level of care; document reasons for declining and note that consistent refusal to accept referrals may prompt a comprehensive review of the agency's approval status.

Maintain documentation of reasons for declining and be aware that repeated refusal of referrals can trigger agency review.

Note

Inform families of administrative fair hearing rights; hearing can change prior authorization

If a family objects to an EOHHS decision about authorization of a Service Plan, they may request an administrative fair hearing; the hearing decision can adjust prior authorization necessary for claims to pay.

Advise families of fair hearing rights and be prepared to adjust authorizations/claims based on hearing outcomes.

Denial Risk

Prepare for EOHHS inspections and potential sanctions; noncompliance risks provisional approval and revocation

EOHHS may inspect records and sites, require corrective action, suspend new referrals up to six months, require recoupment of funds, institute Provisional Approval after 121 days of continued non‑compliance (leading to 90 days of heightened oversight), and may revoke approval for failure to cure deficiencies or violations of Medicaid/state laws.

Maintain readiness for record/site inspections and comply promptly with corrective action plans.
Understand provisional approval and remediation timelines to avoid revocation and financial sanctions.

Note

Definitions and Service Components

PASS — Personal Assistance Services and Supports

DefinitionPersonal Assistance Services and Supports (PASS): assistant services enabling children/adolescents with special health care needs to accomplish tasks they would normally perform if not disabled; funded under EPSDT for Medicaid under age 21.

Purpose domainsSupports activities of daily living (ADLs/IADLs), self‑preserving decision‑making, and participation in social/community settings.

Service modelConsumer‑directed model where families participate in planning, manage and supervise Direct Service Workers to meet Service Plan goals.

Federal definition of disability (for PASS eligibility)

Federal disability definitionA child must have a physical or mental condition (or combination) resulting in marked and severe functional limitations expected to last at least 12 months or result in death.

Program eligibility linkParticipants must also meet EOHHS medical necessity definition to be eligible for PASS.

Medicaid populationPASS serves Medicaid‑eligible children from birth to their 21st birthday who meet the Federal definition of disability.

Direct Services and Direct Service Worker role

DefinitionDirect Services: one‑to‑one personal assistance provided by a Direct Service Worker under the direction of the parent/caregiver in accordance with an individualized approved Service Plan; units are 15 minutes.

Role of Direct Service WorkerPerforms Service Plan activities to support quality and continuity of care, aids family in implementation, and is supervised by designated family supervisor(s).

Medication limitationDirect Service Workers cannot administer medication; medication administration cannot be assigned to unlicensed personnel.

Clinical Consultation — definition and activities

DefinitionClinical Consultation: services by licensed clinical staff to provide support and assessment, enhance family skills, train/supervise Direct Service Workers, and review goals and progress at least bimonthly.

Settings and activitiesMay occur in agency, home, community, or by phone; includes observation of progress, appraisal of worker performance, and recommendations for approaches and techniques.

Documentation roleClinical Consultant assists in writing, reviewing and approving Service Plans and must document and summarize child/family response at conclusion of the 12‑month Service Plan.

PASS — ADLs / IADLs emphasis

PASS intentPASS is intended to support ADLs/IADLs, self‑preserving decision‑making, and community participation, enhancing independence and social integration.

Complementary rolePASS shall complement existing therapeutic services or serve as a step‑down/alternative to other clinical care when indicated.

Not a substitutePASS is not intended to replace school‑based services, licensed mental health treatment, or Private Duty Nursing/CNA services.

Medical Necessity — definition used for determinations

Medical necessity definitionMedical Necessity: services required for prevention, diagnosis, cure, or treatment of a health‑related condition, including services necessary to prevent regression; must be provided cost‑effectively and not solely for convenience.

Decision authorityA physician or other medical service provider's prescription/recommendation is required for determination, but the Medical Assistance Program makes the final determination of medical necessity.

Application to PASSPASS services must meet the Medical Necessity definition to be covered and authorized.

PASS service components — core elements

Component 1: Assessment & Service Plan DevelopmentComprehensive assessment and development of an individualized Service Plan supervised by qualified clinical staff; includes home visit(s) and documentation for authorization.

Component 2: Direct ServicesOne‑to‑one implementation of the Service Plan by Direct Service Workers using 15‑minute units to achieve measurable goals.

Component 3: Service Plan ImplementationOngoing collaboration and technical assistance from PASS Agency to family to support training, supervision, and payroll/administrative functions.

Component 4: Clinical ConsultationLicensed clinical staff provide regular consultation to review goals, train/supervise workers, and document progress toward Service Plan renewal.

Direct Service Worker — minimum qualifications

Minimum ageDirect Service Worker must be at least 18 years of age.

EducationMust have a high‑school diploma or equivalent.

Competency and exclusionsMust demonstrate competency to work with children with special health care needs, ability to carry out Service Plan tasks, have no legal obligation to support the child, and not live in the child's household.

PASS Direct Services — scope and goals

ScopePASS Direct Services provide supports to enhance the child's ability to perform ADLs/IADLs, make self‑preserving decisions, and participate in social roles and settings in the least restrictive environment.

GoalsServices aim to improve adaptive and functional skills, independence, social integration, and quality of life indicators within PASS domains.

ImplementationDirect Services are delivered per the Service Plan with agency oversight, family supervision, and documentation of child's response to interventions.

Consumer‑directed care — family participation model

ModelConsumer‑directed care: families actively participate in planning, management, oversight of the Service Plan, and supervise Direct Service Workers.

Family responsibilitiesFamilies assume risks/responsibilities (e.g., selecting/supervising workers, maintaining safe home environment) and must sign service agreements and job descriptions.

Agency rolePASS Agencies provide training, technical assistance, payroll and administrative support to enable families to manage consumer‑directed services.

Clinical Consultation — acceptable provider types

Acceptable provider typesClinical Consultation must be rendered by licensed clinical staff (e.g., LICSW, licensed mental health clinician, LMFT, licensed OT/PT, licensed psychologist, licensed speech and language therapist) holding valid Rhode Island licenses.

Therapist inclusionOccupational Therapists, Physical Therapists, and Speech and Language Therapists may be included as part of the clinical team and may bill for Clinical Consultation.

Interpreter roleInterpretation (T1013U1) may be used for Clinical Consultations if necessary, up to 2 hours monthly, with certified interpreters experienced with children with special health care needs.

Policy Changes and Effective Dates

2016-07-01Effective dateLatest

Practice standards updated with clarified agency assessment responsibility for treatment intensity, daily hour limits, and authorization rules for children under 6; Service Plans authorized for 12 months with 6-month progress reports.

Operational change

Clinical Consultation (T1027) frequency increased to 2 hours monthly (from 2 hours every 2 months), with additional hours determined case-by-case; interpretation code (T1013U1) may be used up to 2 hours monthly.

Operational change

PASS treatment intensity ceilings established: up to 20 hours/week for PASS alone and up to 25 hours/week combined with HBTS when documented with medical necessity and measurable goals.

Operational change

Maximum of 6 PASS hours per day unless otherwise clinically justified.

Operational change

Prior authorization process revised: PASS requests for children younger than 6 require EOHHS/third-party payer authorization 30 days prior; batch prior authorizations should be sent once weekly for fee-for-service families.

Personal Assistance Services and Supports (PASS) practice standards

Sign up for all Executive Office of Health and Human Services policy alerts

Coverage Criteria and Clinical Eligibility

Service Codes, Units, and Billing Rules

Provider Responsibilities, Authorizations, and Operational Rules

Definitions and Service Components

Policy Background and Scope

Policy Changes and Effective Dates