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