Automated Client Eligibility (ACES) program codes

Revised date
Program ACES Description Scope

SSI and SSI Related

SSI and SSI related also called Aged/Blind/Disabled category

Disability is determined by SSA or by NGMA referral to DDDS

S01 SSI Recipients CNP
  S02 ABD Categorically Needy CNP
  S03 QMB Medicare Savings Program (MSP) Medicare premium and Medicare copays MSP
  S04 QDWI Medicare Savings Program MSP
  S05 SLMB Medicare Savings Program. Medicare Premium only MSP
  S06 QI-1 (SLMB) Medicare Savings Program MSP
  S07 Undocumented Alien - Emergency Related Service Only ERSO
  S95 Medically Needy no Spenddown MNP
  S99 Medically Needy with Spenddown MNP
Program ACES Description Scope

SSI Related living in an Alternative Living Facility (Non Medical Institution) Adult Family Home, boarding home or DDD Group Home

G03 Non Institutional Medical in ALF CNP income under the SIL plus under state rate x 31 days + 38.84 CNP
  G95 Medically Needy Non Institutional in ALF no Spenddown MNP
  G99 Medically Needy Non Institutional in ALF with Spenddown MNP
Program ACES Description Scope
SSI Related Health Care for Workers w/disability S08 Health Care for Workers with Disability CNP Premium based program - Substantial Gainful Activity (SGA) not a factor in Disability determination. CNP
Program ACES Description Scope
Institutional
HCBS Waivers (HCS/DDD) and hospice
L21 DDD/HCS Waiver on SSI CNP
SSI and SSI related L22 DDD/HCS Waiver - gross income under the SIL CNP
  L24  Undocumented alien/noncitizens LTC - residential placement; must be preapproved by ADSA program manager; Emergency related service only (45 slots) ERSO - CNP
  L31 PACE or Hospice on SSI (effective 10/1/2015) CNP
  L32 PACE or Hospice - SSI related (effective 10/1/2015) CNP
  L41 Roads to Community Living (RCL) on SSI (effective 10/1/2015) CNP
  L99 Roads to Community Living - SSI related (effective 10/1/2015) CNP

Noninstitutional community first choice

Personal care services in the community

L51 Community First Choice CFC on SSI (effective 10/1/2015) CNP
  L52 Community First Choice - SSI-Related at home or in an ALF (effective 10/1/2015) CNP
Program ACES Description Scope

Institutional SSI - related

Residing in a medical institution 30 days or more

L01 SSI recipient in a Medical Institution - Residing in a medical institution 30 days or more CNP
  L02 SSI related CNP in a medical institution income under the SIL CNP
  L04 Undocumented alien/non-citizen LTC must be preapproved by ADSA program manager. Emergency related service only (45 slots) ERSO - CNP
  L95 SSI related Medically Needy no Spenddown Income over the SIL; Income under the state rate MNP
  L99 SSI related Medically Needy with Spenddown; Income over the SIL; income over the state rate but under the private rate; locks into state NF rate MNP
Program ACES Description Scope
Institutional family/children TANF related income/resource rules K01 Categorically Needy family in medical institution CNP
  K03 Undocumented Alien family in medical institution - Emergency Related Service Only ERSO
  K95 Family LTC Medically Needy no Spenddown in Medical Institution MNP
  K99 Family LTC Medically Needy with Spenddown - in Medical Institution MNP
Pregnancy P02 Pregnant 185% of FPL & Postpartum Extension CNP
  P04 Undocumented Alien Pregnant Woman CNP
  P05 Family Planning Service Only Family planning
  P06 Take Charge Family Planning Only  
  P99 Medically Needy Pregnant Spenddown MNP
Refugee medical assistance R02 Transitional 4 month extension CNP
  R03 Refugee Categorically needy CNP
Program ACES Description Scope

DCFS/JRA Medical

Foster Care

D01 SSI Recipient FC/AS/JRA Categorically Needy CNP
D02 FC/AS/JRA Categorically Needy CN CNP
D26 Title IV-E Federal Foster Care - Under 26 CN CNP
Family related medical assistance F01 TANF cash and Medicaid (ended 9/30/2013) CNP
  F02 Transitional Medicaid CNP
  F03 Post TANF child/spousal support (4 months max - ended 12/31/2013) CNP
  F04 TANF related CNP
  F05 Newborn CNP
  F06 Categorically needy medical children (effective 1/1/2009, this may be CNP Medicaid children or CNP State funded children) CNP
  F07 Children's health insurance program CNP
  F08 Undocumented alien children (this coverage group ended 12/31/2008 and is merged with the F06 group) CNP
  F09 Undocumented alien - Emergency related service only ERSO
  F10 Interim Categorically needy (2 months max - ended 12/31/2014) CNP
  F99 Medically needy children spenddown  MNP
Program ACES Description Scope
MAGI Family Related MA N01 MAGI Parent/Caretaker Medicaid; Adult CNP
  N02 12 Month Transitional MAGI Parent/Caretaker Medicaid; Adult CNP
  N03 MAGI Pregnancy CNP
  N04 After Pregnancy CNP/ABP
  N05 MAGI Adult Medicaid; Income =<133% (Medicaid Expansion) ABP
  N07 After pregnancy; not Medicaid eligible during pregnancy CNP
  N10 MAGI Newborn Medical Birth to One Year CNP
  N11 MAGI Children's Medicaid/Age Under 19 CNP
  N13 MAGI Children's Health Insurance Program (CHIP) Children Under 19; Premium Payment Program CNP
  N21 MAGI Parents/Caretaker; Emergency Only; AEM ERSO
  N23 MAGI Pregnancy; Not Lawfully Present CNP
  N24 After pregnancy; not lawfully present CNP
  N25 MAGI Adult Medicaid; Noncitizen - Income =<133% (Medicaid Expansion) AEM ERSO
  N27 After pregnancy; not lawfully present; not Medicaid eligible during pregnancy CNP
  N31 MAGI Children's Medical; Under 19; Noncitizen State funded CNP
  N33 MAGI Children's Health Insurance Program (CHIP): Under 19; Premium Payment Program, Noncitizen State funded CNP
ADATSA State program drug & alcohol TX program W01 ADATSA Medical state funded (ended 12/31/2013) State funded
  W02 ADATSA Medical state funded (ended 12/31/2013) State funded
  W03 Detox medical state funded (ended 12/31/2013) State funded
Program ACES Description Scope
Medical care services and ABD cash with CN Medicaid G01 MCS Medical care services (ended 8/31/2014) State funded
  A01 State funded Medical Care Services and ABD Cash Aged/Blind/Disabled State funded
  A05 Medical Care Services non citizen (under 65, incapacitated) State funded
  A24 Medical Care Services non citizen SFA for survivors of certain crimes State funded
  G02

ABD cash plus either:

  • ABD-X Presumptive SSI Federally funded CN Medicaid (ended 12/31/2013)
  • ABD-A Federally funded CNP - AGED (ended 8/31/2014)
  • ABD-D Federally funded CNP - NGMA disability determination (ended 8/31/2014)
CNP
Program ACES Description Scope
Mental health institutional  I01 Inpatient psychiatric (mental health - ended 12/31/2013) CNP
Breast and Cervical Cancer Program S30 Breast and Cervical Cancer (Health Department Approval) CNP
Program ACES Description Scope
Take Charge P06 Family Planning (Take Charge) Family Planning
Psychiatric inpatient M99 Psychiatric indigent inpatient spenddown (MI prior to 7/2003)
Mental health ONLY (ended 12/31/2013)
Inpatient psychiatric hospital only
Tailored supports for older adults (TSOA)
HCS maintains TSOA cases
T02 TSOA - No medical benefits and no Medicaid services card issued
Pre- Medicaid benefit for the caregiver of a person 55 or older to support the caregiver. For those not eligible for a CN or ABP Medicaid program and not needing or eligible for other LTSS services because of resources. Must meet NFLOC.
No medical benefits

CNP = Categorically Needy Program MN = Medically Needy ERSO = Emergency Related Services Only (AEM) MSP = Medicare Savings ABP = Alternative Benefit Plan