Assistance in Supported Independent Living - Weekly

When to use this code

Use this code for Supported Independent Living (SIL) arrangements. SIL provides ongoing support in a shared or individual living setting, helping participants with daily routines, personal care, and household tasks. SIL funding is typically based on a roster of care that maps out support needs across the week.

Common billing scenarios

• A provider delivers this support and claims the quoted rate per week. The claim is submitted with documentation of the support provided.
• A participant receives this support on a regular basis. The provider submits claims after each service delivery with appropriate records.

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.
• This code allows provider travel claims. Travel time to the participant can be billed, but keep in mind the NDIA expects travel to be reasonable. If you are seeing multiple participants in one area, split the travel cost across their plans.
• 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.
• Core supports are the most commonly claimed category. Make sure your service agreements clearly state the code, rate, and cancellation terms. This reduces disputes at claiming time.