Penguin Health
Wyoming · Medicaid · Applied behavior analysis
Wyoming times the signature and caps the day
Wyoming writes its ABA documentation standard into chapter 12.9 of the CMS-1500 Provider Manual, versioned and republished on a steady cadence, currently v20.0, October 1, 2026. The chapter asks for the usual spine of a defensible note, then adds two requirements with edges: the full signature with licensure may not be applied before the service is complete, and each code carries a daily unit maximum: 32 units for 97151 and 97153, 16 for 97155. The matching rule set lives in the rules library in the Penguin Health app.
CMS-1500 Provider Manual, October 1, 2026.
The signature may not predate the end of the service.
8 hours of technician-delivered treatment per day.
4 hours of protocol modification per day.
The manual
What chapter 12.9 requires
The chapter enumerates the per-service record and then constrains it twice: once in time, since the signature cannot be applied before the service is complete, and once in volume, with daily unit maximums per procedure code that a note's own times can contradict.
- The member's name and the covered service with its procedure code, matching the billed line.
- The date, start and end times in standard or military format, and the location of the service.
- All persons involved in the service (technicians, supervisors, caregivers) documented.
- A legible description of the services delivered and the progress toward the identified goals.
- A full signature including the licensure or certification of the treating provider, signed no earlier than service completion.
- Daily unit maximums per code: 32 for 97151, 32 for 97153, 16 for 97155.
The checklist
What a Wyoming ABA note has to show
Each item below names its manual section and the Penguin rule that checks it. Wyoming sets no fixed note-completion deadline, so none is claimed, but the signature may not come before the session ends.
| The note shows | What that means in practice | Source | Rule |
|---|---|---|---|
| The member's name and the billed procedure code | Who, and which covered service, matching the claim. | ch. 12.9 | WY-1 |
| Date, start/end times, and location matching the billing | When and where, agreeing with the claim. | ch. 12.9 | WY-2 |
| All persons involved in the service | Everyone in the room, documented. | ch. 12.9 | WY-3 |
| A legible description of services and progress toward goals | What was delivered and how the client is moving. | ch. 12.9 | WY-4 |
| A full signature with licensure, not signed before completion | Credentialed, and never timestamped before the session ends. | ch. 12.9 | WY-5 |
| Billed units within the daily caps | 32 units for 97151 and 97153, 16 for 97155. | ch. 12.9 | WY-6 |
In the rules library
Six Wyoming rules, ready to turn on
Open the rules library in the Penguin Health app, choose Wyoming Medicaid ABA, and click Add to organization. Rules your organization already has are left alone, so adding the set twice only fills gaps. After adding, edit any rule or add your own alongside them.
Each rule runs only on notes billed to Wyoming Medicaid payers. Penguin checks the CentralReach payer name, so a Wyoming rule never fires on a commercial note in the same organization, and an organization whose payer names differ edits that match after adding the set.
Penguin reads signed session notes from CentralReach, read-only, after signature and before the claim, and runs the set on every note. Deterministic rules compare record fields. AI rules are read by the AI, which returns a pass or fail with a one-sentence reason.
Six rules for Wyoming CMS-1500 manual chapter 12.9: the per-service elements with start/end times, full signatures with licensure, progress toward goals, and daily unit caps.
- reviewed
- Oct 26, 2026
- runs on
- Notes billed to Wyoming Medicaid payers
- sources
- Wyoming Medicaid CMS-1500 Provider Manual v20.0, Oct 1, 2026, ch. 12.9
- watching
- The versioned manual PDF; new versions publish under new paths
Every failure ships with QA guidance for that program code: an educational email, numbered action steps, and a QA email pre-filled with the date of service and a link to the note. Each reviewer action is written to a write-once audit log with seven-year retention. Billing Medicaid in more than one state? The rules library covers twenty-nine, including Colorado and South Dakota.
Maintained by Penguin
We watch the manual so the rules never go stale
Wyoming republishes this manual on a version cadence (v20.0 landed October 1, 2026) and each version can move the chapter. The Wyoming set is tied to the current version.
The versioned manual PDF, which publishes under a new path each release. Penguin fetches the sources on a schedule and archives every revision.
We rewrite the affected rule, cite the document that changed it, and date the review. The set shows its sources and review date in the library.
An updated rule runs in the next scheduled validation and on demand against notes you have already reviewed, so a changed requirement shows you exactly which past notes it touches.
- Manual v20.0 publishes
Chapter 12.9: the per-service elements, the signature-timing requirement, and the daily unit caps.
LibraryWY-1 through WY-6 are built against this version.
- Wyoming set reviewed
Checked against v20.0. Current.
- WatchingThe next version
When the next manual version publishes, the set is updated and every organization using it gets the change.
State alerts
Get an email when Wyoming changes its documentation rules
We fingerprint 56 official payer documents every week, Wyoming's among them. When one changes, a person verifies what changed and writes a short plain-language summary before anything is sent. A few emails a year, not a newsletter. Unsubscribe anytime.
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Next step
Run a month of Wyoming notes through Penguin
Bring one month of session notes. We add the Wyoming set from the rules library, run it, show every finding beside the source it maps to, and hand your QA lead the fix for each one. Or get a demo account and click through Penguin on your own time first.