| Home Health | 251E00000X | Primary |
| Case Manager/Care Coordinator | 171M00000X | |
| Counselor - Pastoral — Pastoral | 101YP1600X | |
| Meals | 174200000X | |
| Clinic/Center - Rehabilitation — Rehabilitation | 261QR0400X | |
| Assisted Living Facility | 310400000X | |
| Assisted Living Facility - Assisted Living, Behavioral Disturbances — Assisted Living, Behavioral Disturbances | 3104A0630X | |
| Adult Companion | 372600000X | |
| Home Health Aide | 374U00000X | |
| Nurse's Aide | 376K00000X | |
| Respite Care | 385H00000X | |
| Custodial Care Facility - Adult Care Home — Adult Care Home | 311ZA0620X | |
| Home Delivered Meals | 332U00000X | |
| Non-emergency Medical Transport (VAN) | 343900000X | |