SKOPH Appendices

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Appendix I, PSU User Guide for the SK-ISP Form
Appendix II, Form H2065-D MDCP Reason for Denial and Comments Language
Appendix III, LTSS Billing Matrix and Crosswalk
Appendix IV, MDCP Frequently Asked Questions
Appendix V, Time Calculation
Appendix VI, STAR Kids Transition Activities
Appendix VII, SASO Service Group, Service Code and Termination Code
Appendix VIII, RUG IPC Cost Limits
Appendix IX, STAR Kids MCOHub Naming Conventions
Appendix X, Income and Resource Limits
Appendix XI, HHSC Benefits Portal and TIERS Reference Guides
Appendix XII, Create an Appeal Task in the HHSC Benefits Portal
Appendix XIII, Long Term Services and Supports
Appendix XIV, State Cutoff Dates
Appendix XV, Guidelines for Completing Form H1746-A, MEPD Referral Cover Sheet
Appendix XVI, MEPD Referral Crosswalk
Appendix XVII, MDCP Eligibility TAC
Appendix XVIII, STAR Kids HEART Naming Conventions
Appendix XIX, Mutually Exclusive Services
Appendix XX, MDCP Program Description
Appendix XXI, Creating an Appeal in TIERS
Appendix XXII, Instructions and Access to CARE
Appendix XXIII, Community First Choice Support Management
Appendix XXIV, MDCP Medical Necessity Denial Attachment - Members
Appendix XXV, Acronyms
Appendix XXVI, STAR Kids Plan Codes
Appendix XXVII, MDCP Medical Necessity Denial Attachment - Applicants
Appendix XXVIII, PSU TMHP LTC Online Portal MDCP Enrollment Form User Guide
Appendix XXIX, Fair Hearing and Interest List Options for Aging Out of MDCP
Appendix XXX, County Codes and City and County List
Appendix XXXI, HEART Case Record Assignment Procedures
Appendix XXXII, STAR Kids Companion Plans
Appendix XXXIII, Scenario Guide for MDCP State Fair Hearing, First Position and Advanced Placement Requests
Appendix XXXIV, CSIL Closure Guide

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