Partial federal government shutdown
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
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 |
|
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 |
S02 | ABD Categorically Needy | CNP |
|
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 |
S03 | QMB Medicare Savings Program (MSP) Medicare premium and Medicare copays | MSP |
|
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 |
S04 | QDWI Medicare Savings Program | MSP |
|
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 |
S05 | SLMB Medicare Savings Program. Medicare Premium only | MSP |
|
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 |
S06 | QI-1 (SLMB) Medicare Savings Program | MSP |
|
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 |
S07 | Undocumented Alien - Emergency Related Service Only | ERSO |
|
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 |
S95 | Medically Needy no Spenddown | MNP |
|
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 |
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 |
| SSI Related living in an Alternative Living Facility (Non Medical Institution) Adult Family Home, boarding home or DDD Group Home | G95 | Medically Needy Non Institutional in ALF no Spenddown | MNP |
| SSI Related living in an Alternative Living Facility (Non Medical Institution) Adult Family Home, boarding home or DDD Group Home | 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 |
| SSI and SSI related | L24 | Undocumented alien/noncitizens LTC - residential placement; must be preapproved by ADSA program manager; Emergency related service only (45 slots) | ERSO - CNP |
| SSI and SSI related | L31 | PACE or Hospice on SSI (effective 10/1/2015) | CNP |
| SSI and SSI related | L32 | PACE or Hospice - SSI related (effective 10/1/2015) | CNP |
| SSI and SSI related | L41 | Roads to Community Living (RCL) on SSI (effective 10/1/2015) | CNP |
| SSI and SSI related | 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 |
|
Noninstitutional community first choice Personal care services in the community |
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 |
|
Institutional SSI - related Residing in a medical institution 30 days or more |
L02 | SSI related CNP in a medical institution income under the SIL | CNP |
|
Institutional SSI - related Residing in a medical institution 30 days or more |
L04 | Undocumented alien/non-citizen LTC must be preapproved by ADSA program manager. Emergency related service only (45 slots) | ERSO - CNP |
|
Institutional SSI - related Residing in a medical institution 30 days or more |
L95 | SSI related Medically Needy no Spenddown Income over the SIL; Income under the state rate | MNP |
|
Institutional SSI - related Residing in a medical institution 30 days or more |
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 |
| Institutional family/children TANF related income/resource rules | K03 | Undocumented Alien family in medical institution - Emergency Related Service Only | ERSO |
| Institutional family/children TANF related income/resource rules | K95 | Family LTC Medically Needy no Spenddown in Medical Institution | MNP |
| Institutional family/children TANF related income/resource rules | K99 | Family LTC Medically Needy with Spenddown - in Medical Institution | MNP |
| Pregnancy | P02 | Pregnant 185% of FPL & Postpartum Extension | CNP |
| Pregnancy | P04 | Undocumented Alien Pregnant Woman | CNP |
| Pregnancy | P05 | Family Planning Service Only | Family planning |
| Pregnancy | P06 | Take Charge Family Planning Only | |
| Pregnancy | P99 | Medically Needy Pregnant Spenddown | MNP |
| Refugee medical assistance | R02 | Transitional 4 month extension | CNP |
| Refugee medical assistance | R03 | Refugee Categorically needy | CNP |
| Program | ACES | Description | Scope |
|---|---|---|---|
|
DCFS/JRA Medical Foster Care |
D01 | SSI Recipient FC/AS/JRA Categorically Needy | CNP |
| FC/AS/JRA Categorically Needy | D02 | CN | CNP |
| Title IV-E Federal Foster Care - Under 26 | D26 | CN | CNP |
| Family related medical assistance | F01 | TANF cash and Medicaid (ended 9/30/2013) | CNP |
| Family related medical assistance | F02 | Transitional Medicaid | CNP |
| Family related medical assistance | F03 | Post TANF child/spousal support (4 months max - ended 12/31/2013) | CNP |
| Family related medical assistance | F04 | TANF related | CNP |
| Family related medical assistance | F05 | Newborn | CNP |
| Family related medical assistance | F06 | Categorically needy medical children (effective 1/1/2009, this may be CNP Medicaid children or CNP State funded children) | CNP |
| Family related medical assistance | F07 | Children's health insurance program | CNP |
| Family related medical assistance | F08 | Undocumented alien children (this coverage group ended 12/31/2008 and is merged with the F06 group) | CNP |
| Family related medical assistance | F09 | Undocumented alien - Emergency related service only | ERSO |
| Family related medical assistance | F10 | Interim Categorically needy (2 months max - ended 12/31/2014) | CNP |
| Family related medical assistance | F99 | Medically needy children spenddown | MNP |
| Program | ACES | Description | Scope |
|---|---|---|---|
| MAGI Family Related MA | N01 | MAGI Parent/Caretaker Medicaid; Adult | CNP |
| MAGI Family Related MA | N02 | 12 Month Transitional MAGI Parent/Caretaker Medicaid; Adult | CNP |
| MAGI Family Related MA | N03 | MAGI Pregnancy | CNP |
| MAGI Family Related MA | N04 | After Pregnancy | CNP/ABP |
| MAGI Family Related MA | N05 | MAGI Adult Medicaid; Income =<133% (Medicaid Expansion) | ABP |
| MAGI Family Related MA | N07 | After pregnancy; not Medicaid eligible during pregnancy | CNP |
| MAGI Family Related MA | N10 | MAGI Newborn Medical Birth to One Year | CNP |
| MAGI Family Related MA | N11 | MAGI Children's Medicaid/Age Under 19 | CNP |
| MAGI Family Related MA | N13 | MAGI Children's Health Insurance Program (CHIP) Children Under 19; Premium Payment Program | CNP |
| MAGI Family Related MA | N20 | MAGI Adult Medical 19 - 64; Income = < 138% Apple Health Expansion | AHE - State funded |
| MAGI Family Related MA | N21 | MAGI Parents/Caretaker; Emergency Only; AEM | ERSO |
| MAGI Family Related MA | N23 | MAGI Pregnancy; Not Lawfully Present | CNP |
| MAGI Family Related MA | N24 | After pregnancy; not lawfully present | CNP |
| MAGI Family Related MA | N25 | MAGI Adult Medicaid; Noncitizen - Income =<133% (Medicaid Expansion) AEM | ERSO |
| MAGI Family Related MA | N27 | After pregnancy; not lawfully present; not Medicaid eligible during pregnancy | CNP |
| MAGI Family Related MA | N31 | MAGI Children's Medical; Under 19; Noncitizen | State funded CNP |
| MAGI Family Related MA | 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 |
| ADATSA State program drug & alcohol TX program | W02 | ADATSA Medical state funded (ended 12/31/2013) | State funded |
| ADATSA State program drug & alcohol TX program | 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 |
| Medical care services and ABD cash with CN Medicaid | A01 | State funded Medical Care Services and ABD Cash Aged/Blind/Disabled | State funded |
| Medical care services and ABD cash with CN Medicaid | A05 | Medical Care Services non citizen (under 65, incapacitated) | State funded |
| Medical care services and ABD cash with CN Medicaid | A24 | Medical Care Services non citizen SFA for survivors of certain crimes | State funded |
| Medical care services and ABD cash with CN Medicaid | G02 |
ABD cash plus either:
|
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 |
| Program | ACES | Description | Scope |
|---|---|---|---|
| Apple Health Eligibility | S20 | Classic Adult Medical 65+; Income = < 138% Apple Health Expansion | AHE - State Funded |
CNP = Categorically Needy Program MNP = Medically Needy Program ERSO = Emergency Related Services Only (AEM) MSP = Medicare Savings ABP = Alternative Benefit Plan