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Data from 2017 calendar year

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


Notes

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).

Minnesota Statutes 256B.69, Subd. 32a.

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.

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