Service Settings
Understanding the allowable service settings for Community Participation Support under Pennsylvania ODP guidelines.
Community Locations
Community locations are the primary setting for CPS delivery. ODP has established clear requirements to ensure genuine community integration.
- Must be non-disability specific locations
- Cannot be in licensed facilities
- Cannot be owned, leased, or operated by another ODP service provider
- Maximum 3 participants per provider at any one community location at any time
- When more than 3 participants are served, facility codes must be used
- SE modifier tracks community participation in billing
Facility-Based Services
When facility-based time exceeds standard thresholds, specific procedures apply:
- Variance requests submitted through the ISP team
- Must be justified by current medical needs
- Or other ISP-team-documented conditions
- Framework established by ODPANN 19-090
- ODP publishes provider-level community participation data
- Drawn from billing to enforce integration expectations