New End Date Reason Codes (HHSC only)

  • Document also available in Portable Document Format (PDF)

The end rate reason codes listed below (2 new) will be used to help manage members with K1 RE codes (New codes cannot be used until updated guidance is issued by HHSC Policy Team-TBD)

  • Reason Code 56: Disenrolled from HH and HCBS
    • when child is disenrolled from Health Home and discharged from HCBS
  • Reason Code 57: Disenrolled from HH only, continue HCBS
    • v.hen child is disenrolled from Health Home and w/1 continue with HCBS

The new end date reason codes are only accepted if member is enrolled in a Children's segment ('C').

If the new end codes are used on an Adult ('A') segment an error message will display, "The End Date Reason is restricted to child-segment only"