Table 1. Number of children (1-6 years old) who received a diagnostic assessment
MCO | Number of children (ages 1-3) | Number of children (ages 4-6) |
---|---|---|
Blue Plus | 477 | 2,059 |
HealthPartners | 267 | 913 |
Hennepin Health | 22 | 52 |
Itasca Medical Care | 4 | 65 |
Medica | 5 | 33 |
PrimeWest | 45 | 313 |
South Country Health Alliance | 23 | 131 |
UCare | 486 | 1,838 |
UnitedHealthcare | 26 | 95 |
MCOs overall | 1,355 | 5,499 |
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 | 1,393 | 1,022 |
HealthPartners | 822 | 631 |
Hennepin Health | 53 | 41 |
Itasca Medical Care | 33 | 18 |
Medica | 43 | 33 |
PrimeWest | 194 | 133 |
South Country Health Alliance | 112 | 62 |
UCare | 1,826 | 1,379 |
UnitedHealthcare | 115 | 69 |
MCOs overall | 4,591 | 3,388 |
Table 3. Number of children (1-6 years old) who received a diagnostic assessment, by procedure code and age
Procedure code | Number of children (1-3 years old) | Number of children (4-6 years old) |
---|---|---|
90785 | 563 | 2,175 |
90791 | 1,024 | 4,461 |
90792 | 14 | 142 |
90887 | 17 | 125 |
96116 | 5 | 122 |
96130 | 311 | 935 |
96138 | 132 | 335 |
96146 | 0 | 12 |
97151 | 230 | 550 |
Table 4. Number of children (1-6 years old) who received a diagnostic assessment, by procedure code and MCO
MCO | 90785 | 90791 | 90792 | 90887 | 96116 | 96130 | 96138 | 96146 | 97151 |
---|---|---|---|---|---|---|---|---|---|
Blue Plus | 6,204 | 2,372 | 82 | 66 | 69 | 504 | 139 | 6 | 1,052 |
HealthPartners | 2,972 | 1,120 | 39 | 11 | 25 | 233 | 68 | 0 | 535 |
Hennepin Health | 188 | 69 | 0 | 1 | 3 | 17 | 9 | 0 | 16 |
Itasca Medical Care | 161 | 55 | 4 | 7 | 7 | 4 | 3 | 0 | 7 |
Medica | 75 | 30 | 1 | 1 | 0 | 7 | 3 | 0 | 3 |
PrimeWest | 1,118 | 343 | 21 | 16 | 3 | 58 | 18 | 6 | 132 |
South Country Health Alliance | 456 | 155 | 4 | 11 | 1 | 20 | 4 | 0 | 40 |
UCare | 5,342 | 2,151 | 28 | 29 | 58 | 555 | 220 | 4 | 1,141 |
UnitedHealthcare | 296 | 99 | 1 | 3 | 5 | 25 | 16 | 0 | 14 |
MCOs overall | 16,812 | 6,394 | 180 | 145 | 171 | 1,423 | 480 | 16 | 2,940 |
Table 5a. 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 who received treatments | # 2-year-olds with ASD | # 2-year-olds who received treatments | # 3-year-olds with ASD | # 3-year-olds who received treatments |
---|---|---|---|---|---|---|
Blue Plus | 14 | 9 | 116 | 92 | 245 | 194 |
HealthPartners | 4 | 2 | 63 | 55 | 148 | 119 |
Hennepin Health | 0 | 0 | 7 | 6 | 8 | 7 |
Itasca Medical Care | 0 | 0 | 2 | 2 | 3 | 3 |
Medica | 0 | 0 | 4 | 3 | 11 | 9 |
PrimeWest | 0 | 0 | 10 | 6 | 27 | 22 |
South Country Health Alliance | 0 | 0 | 5 | 1 | 20 | 12 |
UCare | 11 | 7 | 141 | 114 | 340 | 273 |
UnitedHealthcare | 1 | 1 | 14 | 8 | 14 | 10 |
MHCP overall | 30 | 19 | 362 | 287 | 816 | 649 |
Table 5b. 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 who received treatments | # 5-year-olds with ASD | # 5-year-olds who received treatments | # 6-year-olds with ASD | # 6-year-olds who received treatments |
---|---|---|---|---|---|---|
Blue Plus | 337 | 260 | 348 | 249 | 333 | 218 |
HealthPartners | 209 | 171 | 210 | 164 | 188 | 120 |
Hennepin Health | 10 | 7 | 11 | 7 | 17 | 14 |
Itasca Medical Care | 10 | 5 | 5 | 2 | 13 | 6 |
Medica | 10 | 9 | 10 | 8 | 8 | 4 |
PrimeWest | 48 | 31 | 53 | 36 | 56 | 38 |
South Country Health Alliance | 30 | 16 | 28 | 14 | 29 | 19 |
UCare | 455 | 348 | 438 | 323 | 441 | 314 |
UnitedHealthcare | 20 | 10 | 31 | 19 | 35 | 21 |
MHCP overall | 1,129 | 857 | 1,134 | 822 | 1,120 | 754 |
Table 6a. Blue Plus: Types of treatments provided to children with ASD by procedure code (n=1,393)
Procedure code | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
90832 | Psychotherapy, 30 min | 63 | 154 | 155.0 | 2.5 |
90833 | Psychotherapy with E&M, 30 minutes | 14 | 51 | 51.0 | 3.6 |
90834 | Psychotherapy, 45 min | 125 | 511 | 511.0 | 4.1 |
90836 | Psychotherapy with E&M, 45 min | 2 | 2 | 2.0 | 1.0 |
90837 | Psychotherapy, 60 min | 169 | 1,146 | 1,152.0 | 6.8 |
90838 | Psychotherapy with E&M, 60 min | 0 | 0 | 0.0 | 0.0 |
90839 | Psychotherapy for Crisis, first 60 minutes | 1 | 1 | 1.0 | 1.0 |
90840 | Psychotherapy for Crisis, over 74 minutes | 0 | 0 | 0.0 | 0.0 |
90846 | Family Psychotherapy - Without Patient Present | 256 | 964 | 964.0 | 3.8 |
90847 | Family Psychotherapy - With Patient Present | 197 | 910 | 910.0 | 4.6 |
90849 | Multiple Family Group Psychotherapy | 4 | 36 | 36.0 | 9.0 |
90853 | Group Psychotherapy | 3 | 8 | 8.0 | 2.7 |
90887 | Interpretation of Psychiatric and Other Medical Examination | 7 | 7 | 7.0 | 1.0 |
90899 | Unlisted Psychiatric Service | 30 | 81 | 81.0 | 2.7 |
97153 | EIDBI Intervention – Individual: Adaptive behavior treatment by protocol | 180 | 54,246 | 470,509.0 | 2,613.9 |
97154 | EIDBI Intervention – Group: Group adaptive behavior treatment by protocol | 76 | 10,613 | 32,687.0 | 430.1 |
97155 | Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification | 180 | 16,586 | 101,751.0 | 565.3 |
97156 | Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance | 154 | 2,000 | 8,142.0 | 52.9 |
97157 | Multiple Family Group Adaptive Behavior Treatment Guidance | 5 | 18 | 55.0 | 11.0 |
99499 | Unlisted Evaluation and Management Service | 2 | 2 | 2.0 | 1.0 |
H0031 | Administering and Reporting Standardized Measures | 246 | 492 | 492.0 | 2.0 |
H0032 - CTSS | Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) | 156 | 444 | 489.0 | 3.1 |
H0032 - EIDBI | Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) | 224 | 9,895 | 10,394.0 | 46.4 |
H2012 | Behavioral Health Day Treatment (General Day Treatment) | 69 | 5,551 | 16,286.0 | 236.0 |
H2014 | Skills Training | 80 | 2,133 | 28,310.0 | 353.9 |
H2015 | Crisis Assistance | 3 | 4 | 6.0 | 2.0 |
H2019 | Mental Health Behavioral Aide | 0 | 0 | 0.0 | 0.0 |
T1013 | Sign Language or Oral Interpreter Services | 117 | 900 | 3,524.0 | 30.1 |
T1024 | Evaluation and Treatment by Integrated, Specialty Team | 73 | 297 | 357.0 | 4.9 |
Table 6b. Blue Plus: Types of treatments provided to children with ASD by category of service (n=1,393)
Category of service | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
054 | Occupational Therapy | 643 | 17,114 | 41,459 | 64.5 |
051 | Physical Therapy | 149 | 2,816 | 4,804.0 | 32.2 |
053 | Speech Therapy | 655 | 16,783 | 16,791.0 | 25.6 |
Table 7a. HealthPartners: Types of treatment provided to children with ASD by procedure code (n=822)
Procedure code | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
90832 | Psychotherapy, 30 min | 21 | 78 | 78.0 | 3.7 |
90833 | Psychotherapy with E&M, 30 minutes | 3 | 5 | 5.0 | 1.7 |
90834 | Psychotherapy, 45 min | 54 | 288 | 288.0 | 5.3 |
90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
90837 | Psychotherapy, 60 min | 57 | 331 | 331.0 | 5.8 |
90838 | Psychotherapy with E&M, 60 min | 0 | 0 | 0.0 | 0.0 |
90839 | Psychotherapy for Crisis, first 60 minutes | 1 | 1 | 1.0 | 1.0 |
90840 | Psychotherapy for Crisis, over 74 minutes | 0 | 0 | 0.0 | 0.0 |
90846 | Family Psychotherapy - Without Patient Present | 217 | 847 | 847.0 | 3.9 |
90847 | Family Psychotherapy - With Patient Present | 121 | 435 | 435.0 | 3.6 |
90849 | Multiple Family Group Psychotherapy | 6 | 91 | 91.0 | 15.2 |
90853 | Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90887 | Interpretation of Psychiatric and Other Medical Examination | 4 | 4 | 4.0 | 1.0 |
90899 | Unlisted Psychiatric Service | 22 | 37 | 37.0 | 1.7 |
97153 | EIDBI Intervention – Individual: Adaptive behavior treatment by protocol | 100 | 29,446 | 241,124.0 | 2,411.2 |
97154 | EIDBI Intervention – Group: Group adaptive behavior treatment by protocol | 52 | 10,021 | 30,846.0 | 593.2 |
97155 | Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification | 99 | 8,694 | 50,650.0 | 511.6 |
97156 | Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance | 81 | 1,175 | 3,888.0 | 48.0 |
97157 | Multiple Family Group Adaptive Behavior Treatment Guidance | 1 | 1 | 4.0 | 4.0 |
99499 | Unlisted Evaluation and Management Service | 0 | 0 | 0.0 | 0.0 |
H0031 | Administering and Reporting Standardized Measures | 176 | 370 | 370.0 | 2.1 |
H0032 - CTSS | Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) | 103 | 325 | 325.0 | 3.2 |
H0032 - EIDBI | Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) | 107 | 5,167 | 5,231.0 | 48.9 |
H2012 | Behavioral Health Day Treatment (General Day Treatment) | 83 | 9,642 | 28,482.0 | 343.2 |
H2014 | Skills Training | 25 | 331 | 2,810.0 | 112.4 |
H2015 | Crisis Assistance | 1 | 1 | 2.0 | 2.0 |
H2019 | Mental Health Behavioral Aide | 0 | 0 | 0.0 | 0.0 |
T1013 | Sign Language or Oral Interpreter Services | 100 | 1,224 | 5,119.0 | 51.2 |
T1024 | Evaluation and Treatment by Integrated, Specialty Team | 35 | 215 | 229.0 | 6.5 |
Table 7b. HealthPartners: Types of treatment provided to children with ASD by category of service (n=822)
Category of service | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
054 | Occupational Therapy | 430 | 14,232 | 25,821 | 60.0 |
051 | Physical Therapy | 256 | 14,631 | 15,823.0 | 61.8 |
053 | Speech Therapy | 464 | 15,181 | 15,189.0 | 32.7 |
Table 8a. Hennepin Health: Types of treatment provided to children with ASD by procedure code (n=53)
Procedure code | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
90832 | Psychotherapy, 30 min | 2 | 2 | 2.0 | 1.0 |
90833 | Psychotherapy with E&M, 30 minutes | 0 | 0 | 0.0 | 0.0 |
90834 | Psychotherapy, 45 min | 7 | 34 | 34.0 | 4.9 |
90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
90837 | Psychotherapy, 60 min | 6 | 35 | 35.0 | 5.8 |
90838 | Psychotherapy with E&M, 60 min | 0 | 0 | 0.0 | 0.0 |
90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
90840 | Psychotherapy for Crisis, over 74 minutes | 0 | 0 | 0.0 | 0.0 |
90846 | Family Psychotherapy - Without Patient Present | 18 | 76 | 76.0 | 4.2 |
90847 | Family Psychotherapy - With Patient Present | 8 | 17 | 17.0 | 2.1 |
90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90853 | Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90887 | Interpretation of Psychiatric and Other Medical Examination | 0 | 0 | 0.0 | 0.0 |
90899 | Unlisted Psychiatric Service | 1 | 3 | 3.0 | 3.0 |
97153 | EIDBI Intervention – Individual: Adaptive behavior treatment by protocol | 7 | 901 | 9,053.0 | 1,293.3 |
97154 | EIDBI Intervention – Group: Group adaptive behavior treatment by protocol | 3 | 558 | 1,368.0 | 456.0 |
97155 | Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification | 7 | 151 | 594.0 | 84.9 |
97156 | Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance | 3 | 51 | 152.0 | 50.7 |
97157 | Multiple Family Group Adaptive Behavior Treatment Guidance | 0 | 0 | 0.0 | 0.0 |
99499 | Unlisted Evaluation and Management Service | 0 | 0 | 0.0 | 0.0 |
H0031 | Administering and Reporting Standardized Measures | 15 | 31 | 31.0 | 2.1 |
H0032 - CTSS | Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) | 9 | 261 | 261.0 | 29.0 |
H0032 - EIDBI | Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) | 6 | 124 | 124.0 | 20.7 |
H2012 | Behavioral Health Day Treatment (General Day Treatment) | 6 | 542 | 1,609.0 | 268.2 |
H2014 | Skills Training | 2 | 449 | 7,044.0 | 3,522.0 |
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 | 5 | 33 | 75.0 | 15.0 |
T1024 | Evaluation and Treatment by Integrated, Specialty Team | 3 | 4 | 4.0 | 1.3 |
Table 8b. Hennepin Health: Types of treatment provided to children with ASD by category of service (n=53)
Category of service | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
054 | Occupational Therapy | 29 | 1,022 | 2,950 | 101.7 |
051 | Physical Therapy | 6 | 132 | 267.0 | 44.5 |
053 | Speech Therapy | 26 | 731 | 731.0 | 28.1 |
Table 9a. Itasca Medical Care: Types of treatment provided to children with ASD by procedure code (n=33)
Procedure code | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
90832 | Psychotherapy, 30 min | 3 | 4 | 4.0 | 1.3 |
90833 | Psychotherapy with E&M, 30 minutes | 0 | 0 | 0.0 | 0.0 |
90834 | Psychotherapy, 45 min | 1 | 1 | 1.0 | 1.0 |
90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
90837 | Psychotherapy, 60 min | 5 | 38 | 38.0 | 7.6 |
90838 | Psychotherapy with E&M, 60 min | 0 | 0 | 0.0 | 0.0 |
90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
90840 | Psychotherapy for Crisis, over 74 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 | 4 | 4.0 | 4.0 |
90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90853 | Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90887 | Interpretation of Psychiatric and Other Medical Examination | 0 | 0 | 0.0 | 0.0 |
90899 | Unlisted Psychiatric Service | 0 | 0 | 0.0 | 0.0 |
97153 | EIDBI Intervention – Individual: Adaptive behavior treatment by protocol | 2 | 56 | 839.0 | 419.5 |
97154 | EIDBI Intervention – Group: Group adaptive behavior treatment by protocol | 0 | 0 | 0.0 | 0.0 |
97155 | Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification | 1 | 2 | 20.0 | 20.0 |
97156 | Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance | 1 | 6 | 38.0 | 38.0 |
97157 | Multiple Family Group Adaptive Behavior Treatment Guidance | 0 | 0 | 0.0 | 0.0 |
99499 | Unlisted Evaluation and Management Service | 0 | 0 | 0.0 | 0.0 |
H0031 | Administering and Reporting Standardized Measures | 0 | 0 | 0.0 | 0.0 |
H0032 - CTSS | Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) | 2 | 2 | 2.0 | 1.0 |
H0032 - EIDBI | Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) | 2 | 17 | 24.0 | 12.0 |
H2012 | Behavioral Health Day Treatment (General Day Treatment) | 1 | 9 | 9.0 | 9.0 |
H2014 | Skills Training | 3 | 99 | 461.0 | 153.7 |
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 | 0 | 0 | 0.0 | 0.0 |
T1024 | Evaluation and Treatment by Integrated, Specialty Team | 1 | 2 | 2.0 | 2.0 |
Table 9b. Itasca Medical Care: Types of treatment provided to children with ASD by category of service (n=33)
Category of service | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
054 | Occupational Therapy | 7 | 84 | 161 | 23.0 |
051 | Physical Therapy | 4 | 33 | 69.0 | 17.3 |
053 | Speech Therapy | 12 | 149 | 149.0 | 12.4 |
Table 10a. Medica: Types of treatment provided to children with ASD by procedure code (n=43)
Procedure code | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
90832 | Psychotherapy, 30 min | 2 | 3 | 3.0 | 1.5 |
90833 | Psychotherapy with E&M, 30 minutes | 0 | 0 | 0.0 | 0.0 |
90834 | Psychotherapy, 45 min | 4 | 5 | 5.0 | 1.3 |
90836 | Psychotherapy with E&M, 45 min | 0 | 0 | 0.0 | 0.0 |
90837 | Psychotherapy, 60 min | 3 | 7 | 7.0 | 2.3 |
90838 | Psychotherapy with E&M, 60 min | 0 | 0 | 0.0 | 0.0 |
90839 | Psychotherapy for Crisis, first 60 minutes | 1 | 1 | 1.0 | 1.0 |
90840 | Psychotherapy for Crisis, over 74 minutes | 0 | 0 | 0.0 | 0.0 |
90846 | Family Psychotherapy - Without Patient Present | 10 | 58 | 58.0 | 5.8 |
90847 | Family Psychotherapy - With Patient Present | 2 | 3 | 3.0 | 1.5 |
90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90853 | Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90887 | Interpretation of Psychiatric and Other Medical Examination | 0 | 0 | 0.0 | 0.0 |
90899 | Unlisted Psychiatric Service | 2 | 4 | 4.0 | 2.0 |
97153 | EIDBI Intervention – Individual: Adaptive behavior treatment by protocol | 3 | 142 | 1,233.0 | 411.0 |
97154 | EIDBI Intervention – Group: Group adaptive behavior treatment by protocol | 1 | 216 | 1,374.0 | 1,374.0 |
97155 | Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification | 4 | 70 | 381.0 | 95.3 |
97156 | Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance | 3 | 20 | 74.0 | 24.7 |
97157 | Multiple Family Group Adaptive Behavior Treatment Guidance | 0 | 0 | 0.0 | 0.0 |
99499 | Unlisted Evaluation and Management Service | 0 | 0 | 0.0 | 0.0 |
H0031 | Administering and Reporting Standardized Measures | 6 | 8 | 8.0 | 1.3 |
H0032 - CTSS | Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) | 6 | 11 | 11.0 | 1.8 |
H0032 - EIDBI | Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) | 4 | 57 | 57.0 | 14.3 |
H2012 | Behavioral Health Day Treatment (General Day Treatment) | 5 | 309 | 897.0 | 179.4 |
H2014 | Skills Training | 3 | 100 | 776.0 | 258.7 |
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 | 1 | 2 | 2.0 | 2.0 |
T1024 | Evaluation and Treatment by Integrated, Specialty Team | 1 | 2 | 2.0 | 2.0 |
Table 10b. Medica: Types of treatment provided to children with ASD by category of service (n=43)
Category of service | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
054 | Occupational Therapy | 23 | 675 | 2,000 | 87.0 |
051 | Physical Therapy | 5 | 37 | 68.0 | 13.6 |
053 | Speech Therapy | 26 | 869 | 869.0 | 33.4 |
Table 11a. PrimeWest: Types of treatment provided to children with ASD by procedure code (n=194)
Procedure code | Description | Unique # of children who receive service | Count of services | Total units submitted | Average units |
---|---|---|---|---|---|
90832 | Psychotherapy, 30 min | 10 | 23 | 23.0 | 2.3 |
90833 | Psychotherapy with E&M, 30 minutes | 4 | 10 | 10.0 | 2.5 |
90834 | Psychotherapy, 45 min | 23 | 132 | 132.0 | 5.7 |
90836 | Psychotherapy with E&M, 45 min | 1 | 1 | 1.0 | 1.0 |
90837 | Psychotherapy, 60 min | 26 | 204 | 205.0 | 7.9 |
90838 | Psychotherapy with E&M, 60 min | 0 | 0 | 0.0 | 0.0 |
90839 | Psychotherapy for Crisis, first 60 minutes | 0 | 0 | 0.0 | 0.0 |
90840 | Psychotherapy for Crisis, over 74 minutes | 2 | 2 | 50.0 | 25.0 |
90846 | Family Psychotherapy - Without Patient Present | 15 | 43 | 43.0 | 2.9 |
90847 | Family Psychotherapy - With Patient Present | 16 | 92 | 92.0 | 5.8 |
90849 | Multiple Family Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90853 | Group Psychotherapy | 0 | 0 | 0.0 | 0.0 |
90887 | Interpretation of Psychiatric and Other Medical Examination | 3 | 3 | 3.0 | 1.0 |
90899 | Unlisted Psychiatric Service | 3 | 4 | 4.0 | 1.3 |
97153 | EIDBI Intervention – Individual: Adaptive behavior treatment by protocol | 11 | 2,657 | 20,827.0 | 1,893.4 |
97154 | EIDBI Intervention – Group: Group adaptive behavior treatment by protocol | 4 | 710 | 2,978.0 | 744.5 |
97155 | Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification | 11 | 1,195 | 5,361.0 | 487.4 |
97156 | Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance | 9 | 166 | 888.0 | 98.7 |
97157 | Multiple Family Group Adaptive Behavior Treatment Guidance | 1 | 8 | 33.0 | 33.0 |
99499 | Unlisted Evaluation and Management Service | 0 | 0 | 0.0 | 0.0 |
H0031 | Administering and Reporting Standardized Measures | 18 | 29 | 29.0 | 1.6 |
H0032 - CTSS | Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) | 12 | 20 | 20.0 | 1.7 |
H0032 - EIDBI | Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) | 12 | 717 | 755.0 | 62.9 |
H2012 | Behavioral Health Day Treatment (General Day Treatment) | 1 | 17 | 50.0 | 50.0 |
H2014 | Skills Training | 6 | 36 | 135.0 | 22.5 |
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 | 6 | 15 | 70.0 | 11.7 |
T1024 | Evaluation and Treatment by Integrated, Specialty Team | 9 | 79 | 79.0 | 8.8 |
Table 11b. PrimeWest: Types of treatment provided to children with ASD by category of service (n=194)
Table 12a. South Country Health Alliance: Types of treatment provided to children with ASD by procedure code (n=112)
Table 12b. South Country Health Alliance: Types of treatment provided to children with ASD by category of service (n=112)
Table 13a. UCare: Types of treatments provided to children with ASD by procedure code (n=1,826)
Table 13b. UCare: Types of treatments provided to children with ASD by category of service (n=1,826)
Table 14a. United Healthcare: Types of treatments provided to children with ASD by procedure code (n=115)
Table 14b. United Healthcare: Types of treatments provided to children with ASD by category of service (n=115)
Notes
Minn. Stat. 256B.69, subd. 32aInitiatives 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. |