d. Optional Supplement Codes
An OS code must be annotated for all cases with an assigned residence address with a state code of 09XXX.
(1) OS-A - acceptable only with Federal LA-A
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(a) For 4/78 and continuing, an ‘A’ OS code designates a special supplement is payable to an Adult Foster Care Home resident in a small (50 or fewer residents) Certified Residential Facility.
(b) From 1/74 – 3/78, an ‘A’ OS code designated a special supplement was payable to an Adult Foster Care Home resident, with no differentiation for the resident capacity of the facility
(2) OS-B - acceptable only with Federal LA-A
From 4/78 on, a ‘B’ code designates a special supplement is payable to an Adult Foster Care Home resident in a large (51 or more residents) Certified Residential Facility.
(3) OS-C -- OBSOLETE – acceptable only with Federal LA-A or LA-C
From 10/79 through 12/96, a ‘C’ code designated that a general supplement was payable.
(4) OS-D – OBSOLETE – acceptable only with Federal LA-B
From 10/79 through 4/95, a ‘D’ code designated that a general supplement was payable.
(5) OS-E – OBSOLETE – acceptable only with Federal LA-A with an Essential Person.
From 10/79 through 12/96, an ‘E’ code designated that a general supplement was payable.
(6) OS-F – OBSOLETE – acceptable only with Federal LA-B with an Essential Person.
From 10/79 through 12/96, an ‘F’ code designated that a general supplement was payable.
(7) OS-G – acceptable only with Federal LA-D
For 1/88 and continuing, OS-G indicates that a special supplement is payable to residents of Title XIX facilities.
(8) OS-Y – acceptable with any Federal LA code
This code is used in those rare cases when an individual/couple waives receipt of an optional supplement.
(9) OS-Z
This code designates a “no supplement” case. Currently, a ‘Z’ code is appropriate for DC residents in Federal LA-A (who are not certified residents of Adult Foster Care Homes), Federal LA-B and Federal LA-C.
Supplementation coding and Payment Level charts for the District of Columbia from 1991 through the present are included in Appendix I. If you need charts for periods prior to 1991, contact the SSI Program Support Team in the Philadelphia Regional Office at (215) 597-0435.