Individual Social Skills Development

When to use this code

Use this code for support that builds a participant’s ability to manage daily living tasks more independently. Unlike Core personal care codes (which provide direct hands-on help), this Capacity Building code funds training and skill development. The goal is for the participant to gradually need less support over time.

Common billing scenarios

• A provider delivers 2 hours of this support. They claim 2 hours at $80.06, totalling $160.12.
• A participant receives this support on an ongoing weekly basis. The provider submits claims at the end of each service period, documenting the hours delivered.

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.
• Capacity Building funding is time-limited and goal-oriented. Document how the support contributes to the participant’s plan goals, as this will be reviewed at plan reassessment. Unlike Core funding, Capacity Building budgets are usually not flexible across categories.