300 and MN3 Aid Codes

To be eligible for Medicaid coverage of long term care services (nursing home, HCBS, and PACE), an individual must have income at or below 300% of the SSI one-person standard. Refer to the KC-7000 300% Special Income Limit for Long Term Care located in the Policy Appendix.

• If the consumer’s income is less than or equal to the 300% limit when processing for Long Term Care (LTC), the aid code should be 300/XX.  Staff may enter the default $9,999 as the Cost of Care as it does not impact the determination.

• If the income is over the 300% limit, the share of cost will be compared to the cost of care. The cost of care amount must be entered in the Cost of Care field on the LTC Data Detail page.

NOTE: For a Nursing Facility, the amount would be the daily rate in MMIS multiplied by 31. For Home and Community Based Services (HCBS) and PACE, the rate is listed on relevant forms such as the ES-3160, ES-3161, and ES-3166; if it was not provided, staff must obtain this information to process the case in KEES.

• If the share of cost is less than or equal to the cost of care, the consumer receives an MN3/XX aid code on the EDBC Summary. KEES will do this automatically if all necessary data is entered correctly, especially the Cost of Care.  

• If the patient liability exceeds the cost of care, the individual is not eligible for LTC payment.  In this case, a regular Medically Needy determination should be completed by removing the LTC Data and changing the RMT from LTC to Medical.  This will establish a 6-month base period.  Facility costs may be allowed against the spenddown by entering the information on the Expense page in KEES.