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42.6.9 Personal Care Services
Personal care services are provided to help a child with a disability or chronic condition benefit from special education. Personal care services include a range of human assistance provided to persons with disabilities or chronic conditions which enables them to accomplish tasks that they would normally do for themselves if they did not have a disability. An individual may be physically capable of performing activities of daily living (ADLs) and instrumental ADLs (IADLs) but may have limitations in performing these activities because of a functional, cognitive, or behavioral impairment. For personal care services to be billable, they must be listed in the student's IEP. Personal care services are billable on an individual (1-T1019 with modifier U5 or U6) or group (1-T1019 with modifier U5-UD or U6-UD) basis. Session notes are not required for procedure codes 1-T1019 with modifier U5 or 1-T1019 with modifier U5-UD; however, documentation must include the billable start time, billable stop time, total billable minutes, and must note the type of personal care service that was performed. Procedure codes 1-T1019 with modifier U6 and 1-T1019 with modifier U6-UD are billed using a one-way trip unit of service.
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