Table 1. Number of children (1-6 years old) who received a diagnostic assessment
| MCO | Number of children (age 1-3) | Number of children (age 4-6) |
|---|---|---|
| Blue Plus | 507 | 2,395 |
| HealthPartners | 153 | 798 |
| Hennepin Health | 7 | 26 |
| Itasca Medical Care | 17 | 100 |
| Medica | 26 | 98 |
| PrimeWest | 65 | 319 |
| South Country Health Alliance | 59 | 293 |
| UCare | 280 | 1,044 |
| MCOs overall | 1,114 | 5,073 |
Table 2. Number of children (1-6 years old) with a diagnosis of autism spectrum disorder (ASD) who received treatments
| MCO | Number of children with ASD | Number of children with treatment(s) |
|---|---|---|
| Blue Plus | 697 | 539 |
| HealthPartners | 285 | 208 |
| Hennepin Health | 19 | 12 |
| Itasca Medical Care | 13 | 11 |
| Medica | 36 | 24 |
| PrimeWest | 100 | 81 |
| South Country Health Alliance | 84 | 64 |
| UCare | 488 | 354 |
| MCOs overall | 1,722 | 1,293 |
Table 3a. Number of children (1-3 years old) with a diagnosis of ASD who received treatments, by MCO and age
| MCO | 1-year-olds with ASD | 1-year-olds receiving treatments | 2-year-olds with ASD | 2-year-olds receiving treatments | 3-year-olds with ASD | 3-year-olds receiving treatments |
|---|---|---|---|---|---|---|
| Blue Plus | 6 | 4 | 49 | 40 | 141 | 110 |
| HealthPartners | 5 | 3 | 23 | 19 | 47 | 34 |
| Hennepin Health | 0 | 0 | 3 | 1 | 4 | 2 |
| Itasca Medical Care | 0 | 0 | 0 | 0 | 2 | 2 |
| Medica | 0 | 0 | 3 | 3 | 4 | 3 |
| PrimeWest | 1 | 1 | 5 | 4 | 15 | 13 |
| South Country Health Alliance | 0 | 0 | 7 | 6 | 13 | 10 |
| UCare | 4 | 2 | 43 | 37 | 99 | 77 |
| MHCP overall | 16 | 10 | 133 | 110 | 325 | 251 |
Table 3b. Number of children (4-6 years old) with a diagnosis of ASD who received treatments, by MCO and age
| MCO | 4-year-olds with ASD | 4-year-olds receiving treatments | 5-year-olds with ASD | 5-year-olds receiving treatments | 6-year-olds with ASD | 6-year-olds receiving treatments |
|---|---|---|---|---|---|---|
| Blue Plus | 153 | 122 | 155 | 118 | 193 | 145 |
| HealthPartners | 64 | 50 | 69 | 52 | 77 | 50 |
| Hennepin Health | 4 | 3 | 4 | 3 | 4 | 3 |
| Itasca Medical Care | 3 | 3 | 5 | 3 | 3 | 3 |
| Medica | 9 | 5 | 9 | 8 | 11 | 5 |
| PrimeWest | 28 | 23 | 21 | 18 | 30 | 22 |
| South Country Health Alliance | 22 | 16 | 15 | 12 | 27 | 20 |
| UCare | 104 | 74 | 126 | 89 | 112 | 75 |
| MHCP overall | 387 | 296 | 404 | 303 | 457 | 323 |
Table 4a. Blue Plus: Types of treatments provided to children with ASD by procedure code (n=539)
| Procedure code | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 0359T | Comprehensive Multi-Disciplinary Evaluation (CMDE) | 7 | 16 | 24.0 | 3.4 |
| 0362T | EIDBI Intervention Observation and Direction, first 30 minutes | 7 | 93 | 93.0 | 13.3 |
| 0363T | EIDBI Intervention Observation and Direction, additional 30 minutes | 6 | 36 | 71.0 | 11.8 |
| 0364T | EIDBI Intervention - Individual, first 30 minutes | 9 | 435 | 435.0 | 48.3 |
| 0365T | EIDBI Intervention - Individual, additional 30 minutes | 9 | 420 | 2,373.0 | 263.7 |
| 0366T | EIDBI Intervention - Group, first 30 minutes | 2 | 111 | 111.0 | 55.5 |
| 0367T | EIDBI Intervention - Group, additional 30 minutes | 1 | 94 | 173.0 | 173.0 |
| 0368T | EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes | 3 | 3 | 3.0 | 1.0 |
| 0369T | EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes | 3 | 6 | 16.0 | 5.3 |
| 90832 | Psychotherapy, 30 min | 31 | 108 | 108.0 | 3.5 |
| 90833 | Psychotherapy with E&M, 30 minutes | 8 | 24 | 24.0 | 3.0 |
| 90834 | Psychotherapy, 45 min | 65 | 318 | 318.0 | 4.9 |
| 90836 | Psychotherapy with E&M, 45 min | 3 | 4 | 4.0 | 1.3 |
| 90837 | Psychotherapy, 60 min | 96 | 517 | 517.0 | 5.4 |
| 90839 | Psychotherapy for Crisis, first 60 minutes | 4 | 4 | 4.0 | 1.0 |
| 90840 | Psychotherapy for Crisis, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90846 | Family Psychotherapy - Without Patient Present | 162 | 443 | 443.0 | 2.7 |
| 90847 | Family Psychotherapy - With Patient Present | 137 | 578 | 578.0 | 4.2 |
| 90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90853 | Group Psychotherapy | 3 | 40 | 40.0 | 13.3 |
| 90875 | Biofeedback Training | 0 | 0 | 0.0 | 0.0 |
| 90882 | Environmental Intervention | 0 | 0 | 0.0 | 0.0 |
| 90887 | Interpretation of Psychiatric and Other Medial Examination | 5 | 5 | 5.0 | 1.0 |
| 90899 | Unlisted Psychiatric Service | 29 | 75 | 77.0 | 2.7 |
| 99499 | Psychiatric Consultation (Unlisted Evaluation and Management) | 0 | 0 | 0.0 | 0.0 |
| H0031 | Administering and Reporting Standardized Measures | 33 | 44 | 62.0 | 1.9 |
| H0032 | Individual Treatment Plan Development and Monitoring | 59 | 342 | 1,451.0 | 24.6 |
| H2012 | Behavioral Health Day Treatment (General Day Treatment) | 58 | 4,204 | 12,445.0 | 214.6 |
| H2014 | Skills Training | 98 | 5,354 | 74,409.0 | 759.3 |
| H2015 | Crisis Assistance | 3 | 3 | 10.0 | 3.3 |
| H2019 | Mental Health Behavioral Aide | 11 | 501 | 5,679.0 | 516.3 |
| T1013 | Sign Language or Oral Interpreter Services | 83 | 1,045 | 4,706.0 | 56.7 |
| T1018 | School-based IEP Services, Bundled | 0 | 0 | 0.0 | 0.0 |
| T1024 | EIDBI Coordinated Care Conference | 1 | 1 | 1.0 | 1.0 |
| T1027 | Family/Caregiver Training and Counseling | 5 | 28 | 144.0 | 28.8 |
Table 4b. Blue Plus: Types of treatments provided to children with ASD by category of service (n=539)
| Service category | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 051 | Physical Therapy | 91 | 2366 | 4686 | 51.5 |
| 053 | Speech Therapy | 336 | 8675 | 8678 | 25.8 |
| 054 | Occupational Therapy | 358 | 9083 | 22333 | 62.4 |
Table 5a. HealthPartners: Types of treatment provided to children with ASD by procedure code (n=208)
| Procedure code | Description | Unique number of children receiving service | Count ofservices | Total units submitted | Average units |
|---|---|---|---|---|---|
| 0359T | Comprehensive Multi-Disciplinary Evaluation (CMDE) | 8 | 19 | 19.0 | 2.4 |
| 0362T | EIDBI Intervention Observation and Direction, first 30 minutes | 6 | 35 | 36.0 | 6.0 |
| 0363T | EIDBI Intervention Observation and Direction, additional 30 minutes | 5 | 13 | 13.0 | 2.6 |
| 0364T | EIDBI Intervention - Individual, first 30 minutes | 3 | 30 | 30.0 | 10.0 |
| 0365T | EIDBI Intervention - Individual, additional 30 minutes | 3 | 28 | 134.0 | 44.7 |
| 0366T | EIDBI Intervention - Group, first 30 minutes | 4 | 36 | 36.0 | 9.0 |
| 0367T | EIDBI Intervention - Group, additional 30 minutes | 4 | 31 | 40.0 | 10.0 |
| 0368T | EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes | 6 | 74 | 74.0 | 12.3 |
| 0369T | EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes | 6 | 74 | 184.0 | 30.7 |
| 90832 | Psychotherapy, 30 min | 8 | 23 | 23.0 | 2.9 |
| 90833 | Psychotherapy with E&M, 30 minutes | 6 | 27 | 27.0 | 4.5 |
| 90834 | Psychotherapy, 45 min | 18 | 148 | 148.0 | 8.2 |
| 90836 | Psychotherapy with E&M, 45 min | 2 | 2 | 2.0 | 1.0 |
| 90837 | Psychotherapy, 60 min | 21 | 143 | 143.0 | 6.8 |
| 90839 | Psychotherapy for Crisis, first 60 minutes | 1 | 1 | 1.0 | 1.0 |
| 90840 | Psychotherapy for Crisis, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90846 | Family Psychotherapy - Without Patient Present | 75 | 317 | 317.0 | 4.2 |
| 90847 | Family Psychotherapy - With Patient Present | 54 | 260 | 260.0 | 4.8 |
| 90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90853 | Group Psychotherapy | 4 | 15 | 15.0 | 3.8 |
| 90875 | Biofeedback Training | 0 | 0 | 0.0 | 0.0 |
| 90882 | Environmental Intervention | 0 | 0 | 0.0 | 0.0 |
| 90887 | Interpretation of Psychiatric and Other Medial Examination | 6 | 6 | 7.0 | 1.2 |
| 90899 | Unlisted Psychiatric Service | 9 | 27 | 27.0 | 3.0 |
| 99499 | Psychiatric Consultation (Unlisted Evaluation and Management) | 0 | 0 | 0.0 | 0.0 |
| H0031 | Administering and Reporting Standardized Measures | 39 | 47 | 50.0 | 1.3 |
| H0032 | Individual Treatment Plan Development and Monitoring | 24 | 86 | 443.0 | 18.5 |
| H2012 | Behavioral Health Day Treatment (General Day Treatment) | 48 | 4,976 | 15,656.0 | 326.2 |
| H2014 | Skills Training | 27 | 963 | 11,613.0 | 430.1 |
| H2015 | Crisis Assistance | 0 | 0 | 0.0 | 0.0 |
| H2019 | Mental Health Behavioral Aide | 1 | 26 | 129.0 | 129.0 |
| T1013 | Sign Language or Oral Interpreter Services | 26 | 335 | 1,611.0 | 62.0 |
| T1018 | School-based IEP Services, Bundled | 0 | 0 | 0.0 | 0.0 |
| T1024 | EIDBI Coordinated Care Conference | 0 | 0 | 0.0 | 0.0 |
| T1027 | Family/Caregiver Training and Counseling | 11 | 68 | 309.0 | 28.1 |
Table 5b. HealthPartners: Types of treatment provided to children with ASD by category of service (n=208)
| Service category | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 051 | Physical Therapy | 32 | 767 | 1817 | 56.8 |
| 053 | Speech Therapy | 151 | 3941 | 3942 | 26.1 |
| 054 | Occupational Therapy | 148 | 3740 | 10852 | 73.3 |
Table 6a. Hennepin Health: Types of treatment provided to children with ASD by procedure code (n=12)
| Procedure code | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 0359T | Comprehensive Multi-Disciplinary Evaluation (CMDE) | 1 | 1 | 1.0 | 1.0 |
| 0362T | EIDBI Intervention Observation and Direction, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0363T | EIDBI Intervention Observation and Direction, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0364T | EIDBI Intervention - Individual, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0365T | EIDBI Intervention - Individual, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0366T | EIDBI Intervention - Group, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0367T | EIDBI Intervention - Group, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0368T | EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0369T | EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90832 | Psychotherapy, 30 min | 1 | 1 | 1.0 | 1.0 |
| 90833 | Psychotherapy with E&M, 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90834 | Psychotherapy, 45 min | 1 | 5 | 5.0 | 5.0 |
| 90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
| 90837 | Psychotherapy, 60 min | 1 | 24 | 24.0 | 24.0 |
| 90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
| 90840 | Psychotherapy for Crisis, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90846 | Family Psychotherapy - Without Patient Present | 7 | 38 | 38.0 | 5.4 |
| 90847 | Family Psychotherapy - With Patient Present | 5 | 12 | 12.0 | 2.4 |
| 90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90853 | Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90875 | Biofeedback Training | 0 | 0 | 0.0 | 0.0 |
| 90882 | Environmental Intervention | 0 | 0 | 0.0 | 0.0 |
| 90887 | Interpretation of Psychiatric and Other Medial Examination | 0 | 0 | 0.0 | 0.0 |
| 90899 | Unlisted Psychiatric Service | 1 | 15 | 15.0 | 15.0 |
| 99499 | Psychiatric Consultation (Unlisted Evaluation and Management) | 0 | 0 | 0.0 | 0.0 |
| H0031 | Administering and Reporting Standardized Measures | 3 | 5 | 5.0 | 1.7 |
| H0032 | Individual Treatment Plan Development and Monitoring | 2 | 8 | 23.0 | 11.5 |
| H2012 | Behavioral Health Day Treatment (General Day Treatment) | 5 | 470 | 1,390.0 | 278.0 |
| H2014 | Skills Training | 3 | 32 | 135.0 | 45.0 |
| H2015 | Crisis Assistance | 0 | 0 | 0.0 | 0.0 |
| H2019 | Mental Health Behavioral Aide | 0 | 0 | 0.0 | 0.0 |
| T1013 | Sign Language or Oral Interpreter Services | 8 | 167 | 705.0 | 88.1 |
| T1018 | School-based IEP Services, Bundled | 0 | 0 | 0.0 | 0.0 |
| T1024 | EIDBI Coordinated Care Conference | 0 | 0 | 0.0 | 0.0 |
| T1027 | Family/Caregiver Training and Counseling | 0 | 0 | 0.0 | 0.0 |
Table 6b. Hennepin Health: Types of treatment provided to children with ASD by category of service (n=12)
| Service category | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 051 | Physical Therapy | 0 | 0 | 0.0 | 0.0 |
| 053 | Speech Therapy | 6 | 255 | 255.0 | 42.5 |
| 054 | Occupational Therapy | 6 | 191 | 565.0 | 94.2 |
Table 7a. Itasca Medical Care: Types of treatment provided to children with ASD by procedure code (n=11)
| Procedure code | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 0359T | Comprehensive Multi-Disciplinary Evaluation (CMDE) | 0 | 0 | 0.0 | 0.0 |
| 0362T | EIDBI Intervention Observation and Direction, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0363T | EIDBI Intervention Observation and Direction, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0364T | EIDBI Intervention - Individual, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0365T | EIDBI Intervention - Individual, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0366T | EIDBI Intervention - Group, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0367T | EIDBI Intervention - Group, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0368T | EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0369T | EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90832 | Psychotherapy, 30 min | 2 | 30 | 30.0 | 15.0 |
| 90833 | Psychotherapy with E&M, 30 minutes | 1 | 2 | 2.0 | 2.0 |
| 90834 | Psychotherapy, 45 min | 3 | 8 | 8.0 | 2.7 |
| 90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
| 90837 | Psychotherapy, 60 min | 4 | 18 | 18.0 | 4.5 |
| 90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
| 90840 | Psychotherapy for Crisis, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90846 | Family Psychotherapy - Without Patient Present | 2 | 2 | 2.0 | 1.0 |
| 90847 | Family Psychotherapy - With Patient Present | 1 | 3 | 3.0 | 3.0 |
| 90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90853 | Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90875 | Biofeedback Training | 0 | 0 | 0.0 | 0.0 |
| 90882 | Environmental Intervention | 0 | 0 | 0.0 | 0.0 |
| 90887 | Interpretation of Psychiatric and Other Medial Examination | 0 | 0 | 0.0 | 0.0 |
| 90899 | Unlisted Psychiatric Service | 1 | 3 | 3.0 | 3.0 |
| 99499 | Psychiatric Consultation (Unlisted Evaluation and Management) | 0 | 0 | 0.0 | 0.0 |
| H0031 | Administering and Reporting Standardized Measures | 1 | 1 | 4.0 | 4.0 |
| H0032 | Individual Treatment Plan Development and Monitoring | 4 | 14 | 39.0 | 9.8 |
| H2012 | Behavioral Health Day Treatment (General Day Treatment) | 0 | 0 | 0.0 | 0.0 |
| H2014 | Skills Training | 6 | 301 | 3,688.0 | 614.7 |
| H2015 | Crisis Assistance | 2 | 2 | 8.0 | 4.0 |
| H2019 | Mental Health Behavioral Aide | 0 | 0 | 0.0 | 0.0 |
| T1013 | Sign Language or Oral Interpreter Services | 0 | 0 | 0.0 | 0.0 |
| T1018 | School-based IEP Services, Bundled | 0 | 0 | 0.0 | 0.0 |
| T1024 | EIDBI Coordinated Care Conference | 0 | 0 | 0.0 | 0.0 |
| T1027 | Family/Caregiver Training and Counseling | 0 | 0 | 0.0 | 0.0 |
Table 7b. Itasca Medical Care: Types of treatment provided to children with ASD by category of service (n=11)
| Service category | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 051 | Physical Therapy | 1 | 8 | 19.0 | 19.0 |
| 053 | Speech Therapy | 7 | 92 | 92.0 | 13.1 |
| 054 | Occupational Therapy | 5 | 93 | 177.0 | 35.4 |
Table 8a. Medica: Types of treatment provided to children with ASD by procedure code (n=24)
| Procedure code | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 0359T | Comprehensive Multi-Disciplinary Evaluation (CMDE) | 1 | 3 | 3.0 | 3.0 |
| 0362T | EIDBI Intervention Observation and Direction, first 30 minutes | 1 | 2 | 2.0 | 2.0 |
| 0363T | EIDBI Intervention Observation and Direction, additional 30 minutes | 1 | 1 | 1.0 | 1.0 |
| 0364T | EIDBI Intervention - Individual, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0365T | EIDBI Intervention - Individual, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0366T | EIDBI Intervention - Group, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0367T | EIDBI Intervention - Group, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0368T | EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes | 1 | 5 | 5.0 | 5.0 |
| 0369T | EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes | 1 | 5 | 15.0 | 15.0 |
| 90832 | Psychotherapy, 30 min | 0 | 0 | 0.0 | 0.0 |
| 90833 | Psychotherapy with E&M, 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90834 | Psychotherapy, 45 min | 2 | 4 | 4.0 | 2.0 |
| 90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
| 90837 | Psychotherapy, 60 min | 3 | 13 | 13.0 | 4.3 |
| 90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
| 90840 | Psychotherapy for Crisis, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90846 | Family Psychotherapy - Without Patient Present | 8 | 17 | 17.0 | 2.1 |
| 90847 | Family Psychotherapy - With Patient Present | 6 | 30 | 30.0 | 5.0 |
| 90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90853 | Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90875 | Biofeedback Training | 0 | 0 | 0.0 | 0.0 |
| 90882 | Environmental Intervention | 0 | 0 | 0.0 | 0.0 |
| 90887 | Interpretation of Psychiatric and Other Medial Examination | 0 | 0 | 0.0 | 0.0 |
| 90899 | Unlisted Psychiatric Service | 3 | 10 | 10.0 | 3.3 |
| 99499 | Psychiatric Consultation (Unlisted Evaluation and Management) | 0 | 0 | 0.0 | 0.0 |
| H0031 | Administering and Reporting Standardized Measures | 2 | 2 | 2.0 | 1.0 |
| H0032 | Individual Treatment Plan Development and Monitoring | 4 | 13 | 44.0 | 11.0 |
| H2012 | Behavioral Health Day Treatment (General Day Treatment) | 6 | 267 | 787.0 | 131.2 |
| H2014 | Skills Training | 9 | 219 | 2,060.0 | 228.9 |
| H2015 | Crisis Assistance | 0 | 0 | 0.0 | 0.0 |
| H2019 | Mental Health Behavioral Aide | 1 | 6 | 89.0 | 89.0 |
| T1013 | Sign Language or Oral Interpreter Services | 4 | 73 | 332.0 | 83.0 |
| T1018 | School-based IEP Services, Bundled | 0 | 0 | 0.0 | 0.0 |
| T1024 | EIDBI Coordinated Care Conference | 0 | 0 | 0.0 | 0.0 |
| T1027 | Family/Caregiver Training and Counseling | 1 | 1 | 4.0 | 4.0 |
Table 8b. Medica: Types of treatment provided to children with ASD by category of service (n=24)
| Service category | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 051 | Physical Therapy | 3 | 71 | 183 | 61.0 |
| 053 | Speech Therapy | 18 | 301 | 301 | 16.7 |
| 054 | Occupational Therapy | 17 | 329 | 952 | 56.0 |
Table 9a. PrimeWest: Types of treatment provided to children with ASD by procedure code (n=81)
| Procedure code | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 0359T | Comprehensive Multi-Disciplinary Evaluation (CMDE) | 1 | 5 | 5.0 | 5.0 |
| 0362T | EIDBI Intervention Observation and Direction, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0363T | EIDBI Intervention Observation and Direction, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0364T | EIDBI Intervention - Individual, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0365T | EIDBI Intervention - Individual, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0366T | EIDBI Intervention - Group, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0367T | EIDBI Intervention - Group, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0368T | EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0369T | EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90832 | Psychotherapy, 30 min | 9 | 32 | 32.0 | 3.6 |
| 90833 | Psychotherapy with E&M, 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90834 | Psychotherapy, 45 min | 24 | 182 | 182.0 | 7.6 |
| 90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
| 90837 | Psychotherapy, 60 min | 31 | 197 | 197.0 | 6.4 |
| 90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
| 90840 | Psychotherapy for Crisis, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90846 | Family Psychotherapy - Without Patient Present | 9 | 33 | 33.0 | 3.7 |
| 90847 | Family Psychotherapy - With Patient Present | 12 | 74 | 74.0 | 6.2 |
| 90849 | Multiple Family Group Psychotherapy | 1 | 1 | 1.0 | 1.0 |
| 90853 | Group Psychotherapy | 2 | 12 | 12.0 | 6.0 |
| 90875 | Biofeedback Training | 0 | 0 | 0.0 | 0.0 |
| 90882 | Environmental Intervention | 0 | 0 | 0.0 | 0.0 |
| 90887 | Interpretation of Psychiatric and Other Medial Examination | 10 | 10 | 12.0 | 1.2 |
| 90899 | Unlisted Psychiatric Service | 8 | 27 | 28.0 | 3.5 |
| 99499 | Psychiatric Consultation (Unlisted Evaluation and Management) | 0 | 0 | 0.0 | 0.0 |
| H0031 | Administering and Reporting Standardized Measures | 6 | 12 | 17.0 | 2.8 |
| H0032 | Individual Treatment Plan Development and Monitoring | 11 | 65 | 303.0 | 27.5 |
| H2012 | Behavioral Health Day Treatment (General Day Treatment) | 2 | 117 | 350.0 | 175.0 |
| H2014 | Skills Training | 16 | 485 | 4,196.0 | 262.3 |
| H2015 | Crisis Assistance | 0 | 0 | 0.0 | 0.0 |
| H2019 | Mental Health Behavioral Aide | 2 | 252 | 3,672.0 | 1,836.0 |
| T1013 | Sign Language or Oral Interpreter Services | 1 | 1 | 1.0 | 1.0 |
| T1018 | School-based IEP Services, Bundled | 0 | 0 | 0.0 | 0.0 |
| T1024 | EIDBI Coordinated Care Conference | 0 | 0 | 0.0 | 0.0 |
| T1027 | Family/Caregiver Training and Counseling | 0 | 0 | 0.0 | 0.0 |
Table 9b. PrimeWest: Types of treatment provided to children with ASD by category of service (n=81)
| Service category | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 051 | Physical Therapy | 14 | 299 | 558 | 39.9 |
| 053 | Speech Therapy | 41 | 929 | 929 | 22.7 |
| 054 | Occupational Therapy | 63 | 1,255 | 3,154 | 50.1 |
Table 10a. South Country Health Alliance: Types of treatment provided to children with ASD by procedure code (n=64)
| Procedure code | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 0359T | Comprehensive Multi-Disciplinary Evaluation (CMDE) | 0 | 0 | 0.0 | 0.0 |
| 0362T | EIDBI Intervention Observation and Direction, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0363T | EIDBI Intervention Observation and Direction, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0364T | EIDBI Intervention - Individual, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0365T | EIDBI Intervention - Individual, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0366T | EIDBI Intervention - Group, first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0367T | EIDBI Intervention - Group, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0368T | EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 0369T | EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90832 | Psychotherapy, 30 min | 3 | 10 | 10.0 | 3.3 |
| 90833 | Psychotherapy with E&M, 30 minutes | 2 | 3 | 3.0 | 1.5 |
| 90834 | Psychotherapy, 45 min | 9 | 24 | 24.0 | 2.7 |
| 90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
| 90837 | Psychotherapy, 60 min | 18 | 114 | 114.0 | 6.3 |
| 90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
| 90840 | Psychotherapy for Crisis, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90846 | Family Psychotherapy - Without Patient Present | 13 | 13 | 13.0 | 1.0 |
| 90847 | Family Psychotherapy - With Patient Present | 17 | 181 | 181.0 | 10.6 |
| 90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
| 90853 | Group Psychotherapy | 1 | 1 | 1.0 | 1.0 |
| 90875 | Biofeedback Training | 0 | 0 | 0.0 | 0.0 |
| 90882 | Environmental Intervention | 0 | 0 | 0.0 | 0.0 |
| 90887 | Interpretation of Psychiatric and Other Medial Examination | 2 | 2 | 2.0 | 1.0 |
| 90899 | Unlisted Psychiatric Service | 3 | 6 | 6.0 | 2.0 |
| 99499 | Psychiatric Consultation (Unlisted Evaluation and Management) | 0 | 0 | 0.0 | 0.0 |
| H0031 | Administering and Reporting Standardized Measures | 10 | 23 | 26.0 | 2.6 |
| H0032 | Individual Treatment Plan Development and Monitoring | 13 | 37 | 105.0 | 8.1 |
| H2012 | Behavioral Health Day Treatment (General Day Treatment) | 2 | 152 | 456.0 | 228.0 |
| H2014 | Skills Training | 18 | 800 | 4,836.0 | 268.7 |
| H2015 | Crisis Assistance | 0 | 0 | 0.0 | 0.0 |
| H2019 | Mental Health Behavioral Aide | 7 | 624 | 4,062.0 | 580.3 |
| T1013 | Sign Language or Oral Interpreter Services | 5 | 37 | 123.0 | 24.6 |
| T1018 | School-based IEP Services, Bundled | 0 | 0 | 0.0 | 0.0 |
| T1024 | EIDBI Coordinated Care Conference | 0 | 0 | 0.0 | 0.0 |
| T1027 | Family/Caregiver Training and Counseling | 0 | 0 | 0.0 | 0.0 |
Table 10b. South Country Health Alliance: Types of treatment provided to children with ASD by category of service (n=64)
| Service category | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 051 | Physical Therapy | 10 | 303 | 458 | 45.8 |
| 053 | Speech Therapy | 33 | 742 | 743 | 22.5 |
| 054 | Occupational Therapy | 34 | 758 | 1,590 | 46.8 |
Table 11a. UCare: Types of treatments provided to children with ASD by procedure code (n=354)
| Procedure code | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 0359T | Comprehensive Multi-Disciplinary Evaluation (CMDE) | 9 | 15 | 15.0 | 1.7 |
| 0362T | EIDBI Intervention Observation and Direction, first 30 minutes | 13 | 28 | 28.0 | 2.2 |
| 0363T | EIDBI Intervention Observation and Direction, additional 30 minutes | 2 | 3 | 3.0 | 1.5 |
| 0364T | EIDBI Intervention - Individual, first 30 minutes | 8 | 423 | 444.0 | 55.5 |
| 0365T | EIDBI Intervention - Individual, additional 30 minutes | 8 | 408 | 2,119.0 | 264.9 |
| 0366T | EIDBI Intervention - Group, first 30 minutes | 9 | 426 | 455.0 | 50.6 |
| 0367T | EIDBI Intervention - Group, additional 30 minutes | 9 | 321 | 644.0 | 71.6 |
| 0368T | EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes | 5 | 55 | 55.0 | 11.0 |
| 0369T | EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes | 5 | 55 | 141.0 | 28.2 |
| 90832 | Psychotherapy, 30 min | 15 | 39 | 39.0 | 2.6 |
| 90833 | Psychotherapy with E&M, 30 minutes | 5 | 10 | 10.0 | 2.0 |
| 90834 | Psychotherapy, 45 min | 28 | 166 | 166.0 | 5.9 |
| 90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
| 90837 | Psychotherapy, 60 min | 45 | 310 | 310.0 | 6.9 |
| 90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
| 90840 | Psychotherapy for Crisis, additional 30 minutes | 0 | 0 | 0.0 | 0.0 |
| 90846 | Family Psychotherapy - Without Patient Present | 140 | 523 | 523.0 | 3.7 |
| 90847 | Family Psychotherapy - With Patient Present | 111 | 389 | 389.0 | 3.5 |
| 90849 | Multiple Family Group Psychotherapy | 1 | 22 | 22.0 | 22.0 |
| 90853 | Group Psychotherapy | 3 | 20 | 20.0 | 6.7 |
| 90875 | Biofeedback Training | 0 | 0 | 0.0 | 0.0 |
| 90882 | Environmental Intervention | 0 | 0 | 0.0 | 0.0 |
| 90887 | Interpretation of Psychiatric and Other Medial Examination | 12 | 13 | 13.0 | 1.1 |
| 90899 | Unlisted Psychiatric Service | 21 | 39 | 39.0 | 1.9 |
| 99499 | Psychiatric Consultation (Unlisted Evaluation and Management) | 0 | 0 | 0.0 | 0.0 |
| H0031 | Administering and Reporting Standardized Measures | 64 | 68 | 85.0 | 1.3 |
| H0032 | Individual Treatment Plan Development and Monitoring | 35 | 135 | 463.0 | 13.2 |
| H2012 | Behavioral Health Day Treatment (General Day Treatment) | 78 | 6,004 | 17,861.0 | 229.0 |
| H2014 | Skills Training | 90 | 2,480 | 17,345.0 | 192.7 |
| H2015 | Crisis Assistance | 2 | 4 | 23.0 | 11.5 |
| H2019 | Mental Health Behavioral Aide | 9 | 673 | 7,370.0 | 818.9 |
| T1013 | Sign Language or Oral Interpreter Services | 95 | 1,523 | 6,314.0 | 66.5 |
| T1018 | School-based IEP Services, Bundled | 0 | 0 | 0.0 | 0.0 |
| T1024 | EIDBI Coordinated Care Conference | 3 | 3 | 6.0 | 2.0 |
| T1027 | Family/Caregiver Training and Counseling | 11 | 63 | 262.0 | 23.8 |
Table 11b. UCare: Types of treatments provided to children with ASD by category of service (n=354)
| Service category | Description | Unique number of children receiving service | Count of services | Total units submitted | Average units |
|---|---|---|---|---|---|
| 051 | Physical Therapy | 32 | 458 | 863 | 27.0 |
| 053 | Speech Therapy | 242 | 5,052 | 5,052 | 20.9 |
| 054 | Occupational Therapy | 222 | 4,850 | 13,471 | 60.7 |
1) Data are limited to final version of Minnesota Health Care Programs-paid claims with service dates between Jan. 1, 2017, through Dec. 31, 2017, inclusive.
2) Analysis was limited to children enrolled in a managed-care organization. MCO assignment was selected based on the MCO in which the recipient had the most months of enrollment during the year. If a recipient was enrolled in fee-for-service for the most months during the year, then he or she was excluded from this analysis.
3) Only managed-care claims were included in analysis.
4) Age was calculated as of Dec. 31, 2017.
5) Analysis was limited to children aged 1 through 6.
6) Diagnostic assessments were identified using procedure codes 90791, 90792, 90785, 96101, 96102, 96103 and 90887.
7) Children with a diagnosis of autism spectrum disorder (ASD) were identified with claims having a diagnosis code of 299.0, 299.8, F84.0, F84.2, F84.3, F84.5, F84.8 or F84.9.
8) Treatments for children with a diagnosis of ASD were identified with claims having a procedure code beginning with 908 or equal to H0031, H2012, H2014, H2015, H2019, 99499 (CTSS and other mental health services); having a procedure code of T1013 or T1018 (IEP services); having a procedure code of 0359T, 0362T-0369T, T1024, T1027, H0032 (EIDBI services); or having category of service of 051 (Physical Therapy), 053 (Speech Therapy), or 054 (Occupational Therapy). The service count is the sum of all of the unique services for all of the children in each respective MCO. These counts were de-duplicated using standard DHS procedures.
9) All treatment claims were de-duplicated using standard operating procedures.
10) Analysis was designed in adherence to Minn. Stat. 256B.69, Subd. 32a. (see below).
Initiatives to improve early screening, diagnosis, and treatment of children with autism spectrum disorder and other developmental conditions.
(a) The commissioner shall require managed care plans and county-based purchasing plans, as a condition of contract, to implement strategies that facilitate access for young children between the ages of one and three years to periodic developmental and social-emotional screenings, as recommended by the Minnesota Interagency Developmental Screening Task Force, and that those children who do not meet milestones are provided access to appropriate evaluation and assessment, including treatment recommendations, expected to improve the child's functioning, with the goal of meeting milestones by age five.
(b) The following information from encounter data provided to the commissioner shall be reported on the department's public Web site for each managed care plan and county-based purchasing plan annually by July 31 of each year beginning in 2014:
(1) the number of children who received a diagnostic assessment;
(2) the total number of children ages one to six with a diagnosis of autism spectrum disorder who received treatments;
(3) the number of children identified under clause (2) reported by each 12-month age group beginning with age one and ending with age six; and
(4) the types of treatments provided to children identified under clause (2) listed by billing code, including the number of units billed for each child.
