knowledge/lexical/codes
Source: knowledge/lexical/codes.parquet. Source vintage: Package vintage 2026-10-01; source path partition not dated; inspect record and rule clocks separately. Grain: Packaged source record; inspect schema and linked world method before aggregation. Snapshot: 7a53af6a9beb58928d4a64dc92db09c9db65433f9909f1a10d16e302adaf86ba.
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| node_id UInt32 | code Utf8 | text Utf8 | __row_id Int64 |
|---|---|---|---|
| 12189 Filter to this value Explore graph node | T-1019 Filter to this value | T-1019 criteria: To be eligible for PCA services, the member must be: a. At least 18 years of age; b. His/her own legal guardian; c. Chronically wheelchair-mobile; d. Medically stable and able to participate fully in activities of daily living; e. Able to select and direct the personal care attendant in the implementation of a personal care plan; and f. Able to live in a non-institutional environment without the need for 24-hour care, but requires a minimum of 2 hours of medically oriented care per day. PCA services shall be covered when: 1. Such care is medically oriented 2. Such care is part of a plan of care developed by a Registered Nurse (RN) and prescribed by a physician; 3. Such care is provided in the home or in locations other than the home, if the services would have otherwise been provided in the home 4. The frequency, duration and volume of such care is consistent with the member's demonstrated needs for assistance as documented in the plan of care; 5. The plan of care is reviewed every 60 days by an RN, and 6. Any revisions to the plan of care as a result of the 60-day review are prescribed by a physician disposition: payable-with-criteria payable-with-criteria: PCA services shall be covered when: 1. Such care is medically oriented 2. Such care is part of a plan of care developed by a Registered Nurse (RN) and prescribed by a physician; 3. Such care is provided in the home or in locations other than the home, if the services would have otherwise been provided in the home 4. The frequency, duration and volume of such care is consistent with the member's demonstrated needs for assistance as documented in the plan of care; 5. The plan of care is reviewed every 60 days by an RN, and 6. Any revisions to the plan of care as a result of the 60-day review are prescribed by a physician | 825 |