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provider’s rate is entered on the Request for Payment CC78 or Amended Request for Payment CC79 in the blank labeled PT Month Unit +.

The additional days attended for day twenty-four (24) and beyond are calculated at the part day rate. The part day amount, lesser of the state rate or provider’s rate, is entered on the Request for Payment CC78 or Amended Request for Payment CC79 in the blank labeled PT Day Unit +.

• Notice Days – Ending Care/Changing Providers When the child attends at least one (1) day and the provider includes between one (1) and ten (10) days in the “N” box of the Request for Payment CC78 indicating the child did not attend during some or all of the required ten (10) business day notice period, additional payment is not processed. Payment for the “N” days is included in the part month calculation. The payment verifier will enter a case note on the family’s case the number of notice days paid, the service month they were paid for and the provider’s name and ICCIS number and for PASS II and PASS III families, set an alert in the family’s case, using the date created as the due date. If the family is a PASS I family, the boxes to “Copy” the case note to CMS and “Alert CMS” are also checked.

• Sick Days If a school-aged child attended the provider due to being too ill to attend school, the number of days attended are included in the “SI” box of the Request for Payment CC78 or Amended Request for Payment CC79. Payment for the number of sick days attended through five (5) days shall be calculated at the full day rate, in addition to the part month payment. The full day amount, lesser of the state rate or provider’s rate, is entered on the Request for Payment CC78 or Amended Request for Payment CC79 in the blank labeled FT Day Unit +. • Alaska IN! The Alaska IN! amount of the authorized percentage of a part month plus additional part day rates at the lesser of the state rate or provider’s rate is entered on the Request for Payment CC78 or Amended Request for Payment CC79 the blank labeled AK IN+.