Assistance With Self-Care Activities - High Intensity - Weekday Daytime

When to use this code

Use this code when a participant receives hands-on personal care during standard weekday hours (Monday to Friday, 6am to 8pm). This includes help with showering, dressing, grooming, toileting, or eating. This is the base rate with no penalty loading, making it the most cost-effective option for regular support. If the support happens at a different time, check the related items for the correct time-based code. The wrong time code is a common audit flag.

Common billing scenarios

• A participant receives 2 hours of morning personal care on a Tuesday (shower, dressing, breakfast help). The provider bills 2 hours at $75.98, totalling $151.96.
• A support worker arrives at 9am and assists with medication, meal prep, and light cleaning for 1.5 hours. The personal care portion (medication, grooming) is billed under this code. The cleaning portion should be billed under the household tasks code.
• A participant has a regular Monday to Friday routine of 1 hour of personal care each morning. The provider claims 5 hours per week under this code.

Provider notes

• Non-face-to-face delivery is allowed for this code. This means you can bill for activities like report writing, care coordination calls, or progress notes, provided your service agreement with the participant covers these activities. Keep clear records of what non-face-to-face work was done and how long it took.
• Provider travel can be claimed under this code. You can bill for reasonable travel time to reach the participant, but only for the portion of travel that exceeds normal commuting. Travel costs should be shared proportionally if you are seeing multiple participants in one trip.
• Short notice cancellation fees apply. If a participant cancels with less than 7 clear days notice (or 2 clear business days for some supports), you can charge up to 90% of the agreed fee. You must document the cancellation and have the cancellation policy in your service agreement.
• This is a Core support, which means participants can generally use their Core funding flexibly across different Core categories (unless their plan states otherwise). Check with the participant’s plan manager if you are unsure about flexibility.