Back to Insights and Updates for ProvidersFebruary 2023

Personal care services rate increase

Tufts Health RITogether

The Rhode Island Executive Office of Health and Human Services (EOHHS) has implemented a rate increase of $.19 per 15 minutes for personal care services (S5125 and S5125 U1) that were provided on nights, weekends or holidays, effective for dates of service on or after July 1, 2022. Please use the modifiers listed below to indicate evening, night, weekends, and holidays:

  • UH: Services provided in the evening (3-11 p.m.)
  • UJ: Services provided at night (11 p.m.-7 a.m.)
  • TV: Services provided on weekends and holidays

Tufts Health Plan will automatically reprocess any claims submitted for personal care services between July 1, 2022 and Jan. 25, 2023 with a shift modifier to provide the reimbursement at the applicable rate. To allow providers to resubmit claims for services rendered during the date range listed above that did not previously include a shift modifier, we will waive the timely filing limit for these claims.

Audrey Kleinberg
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Senior Manager, Provider Communications

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