​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​CCS &​ Providers >​ LTSSMaryland​​​ >​ Forms and Billing Documentation​​

LTSS Billing Claims Summary Forms - Exceptions​

These forms are available as a last resort for payment of claims which cannot be paid in LTSS, as the claims are in exception or the system will not allow the services to be entered.

• LTSSMaryland Billing Claims Summary- Exceptions _effective 010124​​
  
• LTSSMaryland Billing Claims Summary- Exceptions _effective 070123​
• LTSSMaryland Billing Claims Summary- Exceptions _effective 070122v3 121522​​
  
• LTSSMaryland Billing Claims Summary- Exceptions _effective 040122​
  
• LTSSMaryland Billing Claims Summary- Exceptions _effective 070121 to 033122 revised​

​Personal Support 2:1 Billing Summary Form

The Personal Support 2:1 Billing Form enables payment for Personal Support services provided by a DSP while another DSP is also providing services.  The first DSP, as directed by the provider, calls into the EVV system, while the provider bills for the services provided by the second DSP on this form.

• FY24 Personal Support 2_1 Summary Form effective 070123​​​​