A program status code is assigned to a budget that contains only members who must be identified by that particular code. The code is added when the budget is opened or when a change in eligibility or circumstances requires the code. The code is removed when it no longer applies. Program status codes are used to identify funding, special reporting requirements, Medicare Buy-In, living arrangements, foster care, etc.
00—No Other Program Status Code Applies
Identifies: A budget that does not require a program status code in order to identify factors such as: Federal funding, special reporting requirements, Medicare Buy-In, living arrangements, foster care, etc.
Categories: All categories.
Exception: Category PS. One of the following program status codes is required with the PS category: 16, 17 or 18.
02—RCA/RMA Refugee Cash/Medical Assistance
Identifies: A refugee who is not TANF eligible, but qualifies under RCA or RMA requirements. Limited to 8 months of eligibility.
Categories: D, PC, PCW, PCN.
03—Refugee Unaccompanied Minor
Identifies: An unaccompanied refugee minor under the custody of the Office of Social Programs. Eligibility ends at age 21.
Categories: PC.
04—Non-Citizen TANF Recipients
Identifies: Budget with a non-citizen subject to 5-year bar on receiving Federal TANF dollars.
Categories: C and U.
05—Repatriated Nationals
Identifies: Budget with a US citizen who was in a foreign country but who had to return to the US due to deportation, political instability, threat of physical harm, loss of property, etc. The US State Department notifies DHS that the individual is in need of assistance.
Categories: D.
06—TANF Time Out
Identifies: Budget with TANF individuals who are eligible for time out.
Categories: C and U.
07—Extended TANF - Contingency
Identifies: Budget with TANF individuals who are in the TANF contingency period.
Categories: C and U.
08—Extended TANF
Identifies: Budget with an individual who has more than 5 years (60) months of TANF.
Categories: C and U.
09—Extended TANF – DV (Domestic Violence)
Identifies: Budget with an individual who has more than 5 years (60) months of TANF, but continues to qualify due to DV issue.
Categories: C and U.
16—Pregnant Woman and Children
Identifies: A pregnant woman or qualified child eligible for Healthy Beginnings.
Categories: PS.
17—Presumptive Eligibility
Identifies: A pregnant woman who has been determined presumptively eligible for Healthy Beginnings by a qualified provider. Eligibility is limited to 45 days.
Categories: PS.
18—Income Ineligible Pregnant Woman/Newborn
Identifies: Pregnant women and children under age one whose income exceeds 185% of the Federal Poverty Income Guidelines but are eligible for continued Medical Assistance coverage even though a change in family income would otherwise make them ineligible.
Categories: PS.
20—Breast and Cervical Cancer Prevention and Treatment
Identifies: Women eligible for Medical Assistance under the Breast and Cervical Cancer Prevention and Treatment, Act 2000, P. L. 106-354, for treatment of breast and cervical cancer including pre-cancerous conditions of the breast and cervix.
Categories: PH.
21—Spend Down Monthly Authorization
Identifies: Eligibility for NMP under the spend-down provisions when a monthly determination is required.
Categories: PC, PU, PD, PA, PJ, and PM.
22—Spend-Down Ongoing Authorization
Identifies: Eligibility for NMP under the spend-down provisions when a monthly determination is not required.
Categories: PC, PU, PD, PA, PJ and PM.
23—Four Month Extended NMP
Identifies: TANF budget whose cash assistance was discontinued due to receipt of support. Limited to four months.
Categories: PC and PU.
27—NMP for the Family
Identifies: Family determined ineligible for TANF but eligible for NMP-MA as a single budget using the TANF eligibility rules including child care deductions. This also includes families who would be eligible for TANF if they decided to apply for it.
Categories: PC and PU.
29—GA Health Sustaining Medication
Identifies: Individual who relies on health-sustaining medication to maintain employability.
Categories: PD.
NOTE: This program status code is being phased out with the implementation of MEDA and is replaced by PD00H.
30—Release from Youth Development Center (YDC) Youth Forestry Camp (YFC)
Identifies: Budget with a former SSI recipient who is released from a State YDC/YFC. The CAO makes a referral to SSA to reinstate benefits.
Categories: PC.
31—Federal Foster Care
Identifies: Budget with a child under placement with the County Children and Youth agency who is determined eligible for Placement Maintenance benefits under the Title IV-E Federal Adoption Assistance Program.
Categories: PC, PCN and J.
32—Federal Adoption Assistance
Identifies: Budget with a child adopted under the Title IV-E Adoption Assistance Program.
Categories: PC, PCN and J.
33—State Foster Care
Identifies: Budget with a foster child who is eligible for Medical Assistance, but does not meet the requirements for Placement Maintenance under the Title IV-E Federal Adoption Assistance Program.
Categories: PC, PCN and J.
34—State Adoption Assistance
Identifies: Child adopted under the State Adoption Assistance Program. The child does not meet the requirements of the IV-E Federal Adoption Assistance Program.
Categories: PC, PCN.
35—Adoption Assistance/Foster Care from Another State
Identifies: Budget with a child who has been placed in a home in Pennsylvania by the child welfare agency of another state. The child may or may not meet the requirements of the Title IV-E Federal Adoption Assistance Program.
Categories: PC, PCN and J.
36—Federal Adoption Assistance from Another State
Identifies: Budget with a child who has been placed in a home in Pennsylvania by the child welfare agency of another state. The child may or may not meet the requirements of the Title IV-E Federal Adoption Assistance Program. Coverage ends at age 18.
Categories: PC, PCN and J.
37—Subsidized Permanent Legal Custodian (SPLC)
Identifies: Budget with a child in SPLC who receives Medical Assistance. The child may or may not meet the requirements of the Title IV-E Federal Adoption Assistance Program.
Categories: PC, PCN and J.
38—Inmate of State Correctional Institutions (SCI)
Identifies: Inmates admitted to the hospital for Inpatient Care.
Categories: PC, PH, PD.
39—Inmates of County Correctional Institutions
Identifies: County inmates admitted to the hospital for Inpatient Care.
Categories: PC, PH, PD.
41—FS Homeless HH Special Issuance (FS)
Identifies:
Categories:
42—FS Homeless HH Special Issuance (FS)
Identifies:
Categories:
43—Food Stamp Program/Transitional Benefits Alternative
Identifies: An individual receiving transitional food stamp benefits who has earned income and no longer qualifies for TANF.
Categories: FS.
44—State Supplementary Payment (SSP)
Identifies: SSI recipients who are only eligible for the SSP and Medical Assistance. The individual’s income exceeds the Federal Benefit Rate (FBR) for an SSI cash payment, but is less than the combined FBR and State SSP payment level.
Categories: A, J, and M.
45—SSI Title XIX Nursing Home Budgets
Identifies: An individual eligible for Supplemental Security Income that is residing in a nursing home and not eligible for a State Supplementary Payment.
Categories: A, J, and M.
46—SSI Essential Person and Mandatory Budgets
Identifies: An individual who was a recipient of Old Age Assistance, Aid to the Blind or Aid to the Disabled cash payments as of December 31, 1973. This individual receives a federally-administered State Supplementary Payment that must provide the same total income that was available in December 1973.
Categories: A, J, and M.
47—TANF Diversion
Identifies: Budget open for a one-month Family Size Allowance (FSA) for TANF Diversion.
Categories: C and U.
NOTE: Diversion recipients are not eligible for Medical Assistance.
48—TANF Diversion
Identifies: Budget open for a two-month Family Size Allowance (FSA) for TANF Diversion.
Categories: C and U.
NOTE: Diversion recipients are not eligible for Medical Assistance.
49—TANF Diversion
Identifies: Budget open for a three-month Family size Allowance (FSA) for TANF Diversion.
Categories: C and U.
NOTE: Diversion recipients are not eligible for Medical Assistance.
50—DAP - SSI/RSDI Pending Eligibility
Identifies: A GA-related cash recipient who is disabled and has been referred to the Disability Advocacy Program (DAP), applied for SSI, is in the appeal process or has been certified disabled by the Medical Review Team (MRT).
Categories: D.
51—(Reserved)
52—(Reserved)
53—Work Support Component (WSC) Phase II
Identifies: TANF Budget with individuals not meeting the work support requirements.
Categories: C, U.
54—Work Support Component (WS)
Identifies: TANF parent is providing care for a disabled family living in the home who does not attend school on a full time basis.
Categories: C, U.
55—GA Medical Assessment
Identifies: An individual authorized as a Noncontinuous Eligibility (NCE) for 30 days of limited Medical Assistance benefits pending verification of a disability to establish GA or GA-related MA (PD) eligibility.
Categories: TD.
56—Work Support Component (WSC)
Identifies: TANF budget with individual(s) who are required to participate in an immediate structured job-readiness and job-search program.
Categories: C and U.
57—Work Support Component (WSC) Phase II
Identifies: TANF-Extended TANF Contingency not meeting the work support requirements.
Categories: C, U.
58—Work Support Component (WSC) Phase II
Identifies: TANF-Extended TANF not meeting the work support requirements.
Categories: C, U.
59—Work Support Component (WSC) Phase II
Identifies: TANF Domestic Violence prevents compliance with work support requirements.
Categories: C, U.
60—Individual/Couple Receiving Domiciliary Care Supplement
Identifies: An SSI individual/couple who receives a full or partial Domiciliary Care Supplement. The code is entered when the CAO sends the PA 747 to SSA authorizing the supplement or when the CAO receives information from SSA through IEVS Exchange 6 (SDX) indicating eligibility for the Domiciliary Care supplement.
Categories: A, J, and M.
61—(Reserved)
62—Individual/Couple Receiving PCBH Supplement
Identifies: An SSI individual/couple who receives a full or partial Personal Care Boarding Home Supplement. The code is entered when the CAO sends the PA 747 to SSA authorizing the supplement or when information is received from SSA, whichever is earlier.
Categories: A, J, and M.
63—(Reserved)
65—Specified Low Income Medicare Beneficiaries - Medicare Part B Only
Identifies: Elderly and disabled individuals with income more than 100% of the Federal Poverty Income Guidelines (FPIGs) but less than 120% and who are eligible for payment of Medicare Part B only.
Categories: TA and TJ.
66—Specified Low Income Medicare Beneficiaries - Medicare Part B and Medically Needy Only
Identifies: Elderly, blind and disabled individuals with income more than 100% of FPIGs but less than 120% and are eligible for payment of Medicare Part B and Medical Assistance benefits.
Categories: PAN, PAW, PJN, PJW, PMN, PMW, PI, PVN, PW, TA, TJ, TVN.
67—Qualifying Individual, Group 1 - Medicare Part B Only
Identifies: Elderly and disabled individuals with income of at least 120% of FPIGs but less than 135% and who are eligible for payment of Medicare Part B only.
Categories: TA and TJ.
NOTE: QI recipients are not eligible for other Medical Assistance benefits.
68—(Reserved)
70—(Reserved)
71—EMC Eligible
Identifies: A budget with an individual eligible for extended NMP-Medical Assistance for up to 12 months
Categories: PC and PU.
72—(Reserved)
73—(Reserved)
74—(Reserved)
75—(Reserved)
76—(Reserved)
77—(Reserved)
80—Elderly/Blind/Disabled Buy-In
Identifies: A budget with an elderly recipient of State Blind Pension or an elderly, blind or disabled Medical Assistance recipient who is eligible for Buy-In of Part-B Medicare premium and coinsurance/deductibles.
Categories: B, TB, PAN, PAW, PH, PJN, PJW, PMN, PMW, PI, PVN, PW, TA, TJ, TVN.
81—Disabled Adult Child (NMP)
Identifies: A budget with a Disabled Adult Child (DAC). A DAC is an individual who became disabled before age 22, and who receives Title II Social Security benefits as a dependent on his parent’s claim. These benefits are received upon the disability, retirement or death of the parent. When SSI benefits are terminated because of receipt of or an increase in Social Security benefits, a DAC may be eligible for continued MA coverage under SSI Extended NMP Coverage – Special Circumstances. PSC 81 identifies DACS who continue to be eligible for Medical Assistance.
Categories: PA, PJ, PM.
82—Family Works
Identifies: An individual who receives work support and services funded with TANF funds. These services are not considered assistance and do not count toward the 60-month TANF limit.
Categories: SC.
83—Disabled Widows and Widowers, Loss of SSI
Identifies: A budget with a disabled widow/widower who lost SSI due to entitlement to Title II benefits or to an increase in Title II benefits.
Categories: PJ.
84—Lynch vs. Rank, Pickle, Loss of SSI
Identifies: A budget with an individual who remains eligible for Medical Assistance as a result of Lynch vs. Rank. Title II Cost of Living Adjustments (COLAS) are disregarded.
Categories: PJ, PA, PM.
85—Disabled – Employment, Loss of SSI
Identifies: A budget with a blind or disabled individual whose earnings from Employment make the individual ineligible for an SSI cash payment. The SSA makes the determination for “Special SSI Recipient Status.”
Categories: PJ, PA, PM.
86—Qualified Disabled Working Individuals
Identifies: An individual who, although disabled, lost Title II eligibility due to an increase in earnings. The only benefit is payment of the Medicare Part A premium.
Categories: PA, PJ and PM.
87—Bridge Program
Identifies: An individual who is aged or disabled and qualifies for the State-Funded Waiver Program administered by Department of Aging. This is not a Medical Assistance program. This program officially ended 7/1/05 for any new applicants. However, there are still some remaining budgets open.
Categories: PA and PJ.
90—(Reserved)
95—Children With Special Needs
Identifies: A child under age 18 who is disabled and whose parental income is not considered in the financial determination of Medical Assistance eligibility.
Categories: PH.
97—SSI Pending/Child – Pilot - Philadelphia
Identifies: A child whose family filed an SSI application for the child. Medical Assistance is authorized while SSI eligibility is being determined for the child.
NOTE: This category/program status combination is only used in Philadelphia for the pilot project “Bridging the GAP.”
Categories: PH.
98—SSI Ineligible/Medical Assistance Eligible
Identifies: A child under age 18 who is no longer eligible for SSI, but remains eligible for Medical Assistance coverage. This is a special group of children grandfathered in for Medical Assistance by the Balanced Budget Act (BBA of 1997, P. L. 105-33).
Categories: PJ.
Updated February 14, 2012, Replacing January 29, 2010