Attention: Community Alternatives Program for Children (CAP/C) Stakeholders Announcement of the expiration of two CAP/C HCPCS codes

The single G-code of G0154 for skilled nursing services expired effective Dec. 31, 2015. Claims for G0154 submitted with a date of service on or after Jan.1, 2016 will deny. The Community Alternatives Program for Children (CAP/C) Unit is in the process of establishing replacement HCPCS codes for G0154 and G0156 specific to the CAP/C waiver.

Claims that were denied due to expired G-codes should be resubmitted for payment when the replacement codes are available. The replacements codes for G0154 and G0156 should be available to use by June 2016 and will be retroactive to Jan. 1, 2016.