The size and age limitations for customized living, also known as the "under 55 rule" are rules agreed upon between the state and federal government designed to decrease congregate settings in favor of independent living options for younger adults with disabilities. These rules affect authorization and billing for each client under 55. When exceptions are required, they must be obtained for each client under 55. Generally speaking, the rules are stricter than the provider community has understood them. Because the rules are complicated, there have been some instances of case managers authorizing services incorrectly for clients under 55. Check your settings for compliance with these two rules now to avoid being denied authorizations when service agreements are initiated or renewed.