Data from 2024 calendar year

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 514 2,109
HealthPartners 304 941
Hennepin Health 25 57
Itasca Medical Care 10 48
Medica 10 50
PrimeWest 58 324
South Country Health Alliance 28 141
Ucare 626 2,072
United Healthcare 51 150
MCOs Overall 1,626 5,892


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 1,556 1,151
HealthPartners 910 692
Hennepin Health 62 51
Itasca Medical Care 27 15
Medica 65 51
PrimeWest 200 141
South Country Health Alliance 112 75
Ucare 1,959 1,497
United Healthcare 136 87
MCOs Overall 5,027 3,760


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 456 2,147
90791 1,188 4,793
90792 13 186
90887 24 99
96116 19 112
96130 354 925
96138 203 335
96146 0 12
97151 318 681


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 6,682 2,451 109 57 71 484 199 5 1,226
HealthPartners 3,046 1,183 41 10 17 216 89 1 855
Hennepin Health 187 79 0 0 2 13 5 0 41
Itasca Medical Care 70 67 0 1 2 1 3 0 11
Medica 115 52 0 0 2 13 10 0 15
PrimeWest 1,151 372 17 9 6 80 23 6 122
South Country Health Alliance 564 154 4 22 3 22 3 0 56
UCare 5,350 2,534 58 27 74 601 221 6 1,570
United Healthcare 394 182 2 2 2 29 25 1 49
MCOs Overall 17,559 7,074 231 128 179 1,459 578 19 3,945


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 9 6 99 77 276 219
HealthPartners 5 4 57 47 163 123
Hennepin Health 0 0 9 9 12 12
Itasca Medical Care 0 0 4 4 4 2
Medica 1 1 5 5 10 5
PrimeWest 0 0 9 6 38 27
South Country Health Alliance 3 2 9 6 18 12
UCare 13 6 155 114 352 281
United Healthcare 1 1 9 6 24 22
MHCP Overall 32 20 356 274 897 703


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 345 257 424 314 403 278
HealthPartners 200 162 266 208 219 148
Hennepin Health 13 12 10 7 18 11
Itasca Medical Care 3 3 12 4 4 2
Medica 20 14 18 16 11 10
PrimeWest 33 24 59 42 61 42
South Country Health Alliance 27 18 26 18 29 19
Ucare 462 359 517 402 460 335
United Healthcare 34 20 38 22 30 16
MHCP Overall 1,137 869 1,370 1,033 1,235 861


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 72 243 243.0 3.4
90833 Psychotherapy with E&M, 30 minutes 14 37 37.0 2.6
90834 Psychotherapy, 45 min 132 527 527.0 4.0
90836 Psychotherapy with E&M, 45 min 1 1 1.0 1.0
90837 Psychotherapy, 60 min 135 898 942.0 7.0
90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
90839 Psychotherapy for Crisis, first 60 minutes 2 5 5.0 2.5
90840 Psychotherapy for Crisis, over 74 minutes 0 0 0.0 0.0
90846 Family Psychotherapy - Without Patient Present 213 646 646.0 3.0
90847 Family Psychotherapy - With Patient Present 178 736 737.0 4.1
90849 Multiple Family Group Psychotherapy 2 12 12.0 6.0
90853 Group Psychotherapy 4 22 22.0 5.5
90887 Interpretation of Psychiatric and Other medical Examination 10 10 10.0 1.0
90899 Unlisted Psychiatric Service 40 72 72.0 1.8
97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 242 76,343 672,031.0 2,777.0
97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 79 9,393 33,214.0 420.4
97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 237 31,890 192,978.0 814.3
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 203 3,461 15,244.0 75.1
97157 Multiple Family Group Adaptive Behavior Treatment Guidance 9 22 79.0 8.8
99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
H0031 Administering and Reporting Standardized Measures 205 332 337.0 1.6
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 164 914 953.0 5.8
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 294 23,552 23,730.0 80.7
H2012 Behavioral Health Day Treatment (General Day Treatment) 64 5,370 14,097.0 220.3
H2014 Skills Training 80 1,948 17,484.0 218.6
H2015 Crisis Assistance 6 6 7.0 1.2
H2019 Mental Health Behavioral Aide 0 0 0.0 0.0
T1013 Sign Language or Oral Interpreter Services 114 468 1,895.0 16.6
T1024 Evaluation and Treatment by Integrated, Specialty Team 145 712 718.0 5.0


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 717 18,691 45,231 63.1
051 Physical Therapy 151 3,384 5,870.0 38.9
053 Speech Therapy 767 20,362 20,380.0 26.6


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 28 62 62.0 2.2
90833 Psychotherapy with E&M, 30 minutes 2 2 2.0 1.0
90834 Psychotherapy, 45 min 48 294 294.0 6.1
90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
90837 Psychotherapy, 60 min 54 356 356.0 6.6
90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
90839 Psychotherapy for Crisis, first 60 minutes 2 5 5.0 2.5
90840 Psychotherapy for Crisis, over 74 minutes 1 2 4.0 4.0
90846 Family Psychotherapy - Without Patient Present 200 628 628.0 3.1
90847 Family Psychotherapy - With Patient Present 134 384 384.0 2.9
90849 Multiple Family Group Psychotherapy 5 42 42.0 8.4
90853 Group Psychotherapy 3 16 16.0 5.3
90887 Interpretation of Psychiatric and Other medical Examination 2 2 2.0 1.0
90899 Unlisted Psychiatric Service 23 57 58.0 2.5
97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 152 32,411 308,997.0 2,032.9
97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 57 6,612 23,898.0 419.3
97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 151 13,795 88,773.0 587.9
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 124 1,718 7,737.0 62.4
97157 Multiple Family Group Adaptive Behavior Treatment Guidance 2 5 20.0 10.0
99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
H0031 Administering and Reporting Standardized Measures 173 378 378.0 2.2
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 147 289 289.0 2.0
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 168 10,218 10,229.0 60.9
H2012 Behavioral Health Day Treatment (General Day Treatment) 95 9,706 24,882.0 261.9
H2014 Skills Training 23 476 3,573.0 155.3
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 100 1,087 4,671.0 46.7
T1024 Evaluation and Treatment by Integrated, Specialty Team 68 183 183.0 2.7


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
54 Occupational Therapy 449 13,669 26,797 59.7
51 Physical Therapy 263 12,701 14,002.0 53.2
53 Speech Therapy 505 16,146 16,148.0 32.0


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 3 3 3.0 1.0
90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
90834 Psychotherapy, 45 min 4 13 13.0 3.3
90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
90837 Psychotherapy, 60 min 2 6 6.0 3.0
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 23 64 64.0 2.8
90847 Family Psychotherapy - With Patient Present 9 62 62.0 6.9
90849 Multiple Family Group Psychotherapy 3 9 9.0 3.0
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 9 1,884 20,359.0 2,262.1
97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 5 1,006 3,131.0 626.2
97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 8 310 2,016.0 252.0
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 7 121 466.0 66.6
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 21 39 39.0 1.9
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 15 23 23.0 1.5
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 9 344 344.0 38.2
H2012 Behavioral Health Day Treatment (General Day Treatment) 5 453 1,007.0 201.4
H2014 Skills Training 3 20 71.0 23.7
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 13 48 137.0 10.5
T1024 Evaluation and Treatment by Integrated, Specialty Team 4 10 10.0 2.5


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 32 690 1,728 54.0
051 Physical Therapy 6 94 206.0 34.3
053 Speech Therapy 41 884 884.0 21.6


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 1 1 1.0 1.0
90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
90834 Psychotherapy, 45 min 2 2 2.0 1.0
90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
90837 Psychotherapy, 60 min 2 9 9.0 4.5
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 3 16 16.0 5.3
90847 Family Psychotherapy - With Patient Present 2 7 7.0 3.5
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 0 0 0.0 0.0
97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 0 0 0.0 0.0
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 0 0 0.0 0.0
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 0 0 0.0 0.0
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 1 2 2.0 2.0
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 3 4 4.0 1.3
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 0 0 0.0 0.0
H2012 Behavioral Health Day Treatment (General Day Treatment) 0 0 0.0 0.0
H2014 Skills Training 4 215 1,297.0 324.3
H2015 Crisis Assistance 1 1 4.0 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
T1024 Evaluation and Treatment by Integrated, Specialty Team 0 0 0.0 0.0


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
54 Occupational Therapy 7 91 202 28.9
51 Physical Therapy 4 22 31.0 7.8
53 Speech Therapy 10 163 163.0 16.3


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 4 4.0 2.0
90833 Psychotherapy with E&M, 30 minutes 1 2 2.0 2.0
90834 Psychotherapy, 45 min 3 24 24.0 8.0
90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
90837 Psychotherapy, 60 min 5 18 18.0 3.6
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 18 40 40.0 2.2
90847 Family Psychotherapy - With Patient Present 12 35 35.0 2.9
90849 Multiple Family Group Psychotherapy 1 25 25.0 25.0
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 9 2,192 15,792.0 1,754.7
97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 2 365 1,309.0 654.5
97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 8 772 3,500.0 437.5
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 7 135 443.0 63.3
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 10 19 19.0 1.9
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 8 15 15.0 1.9
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 10 429 437.0 43.7
H2012 Behavioral Health Day Treatment (General Day Treatment) 4 443 1,269.0 317.3
H2014 Skills Training 1 8 24.0 24.0
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 2 4 12.0 6.0
T1024 Evaluation and Treatment by Integrated, Specialty Team 2 5 5.0 2.5


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
54 Occupational Therapy 33 700 1,769 53.6
51 Physical Therapy 5 30 62.0 12.4
53 Speech Therapy 39 941 941.0 24.1


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 12 47 47.0 3.9
90833 Psychotherapy with E&M, 30 minutes 1 1 1.0 1.0
90834 Psychotherapy, 45 min 38 145 145.0 3.8
90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
90837 Psychotherapy, 60 min 36 372 372.0 10.3
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 31 57 57.0 1.8
90847 Family Psychotherapy - With Patient Present 21 119 119.0 5.7
90849 Multiple Family Group Psychotherapy 0 0 0.0 0.0
90853 Group Psychotherapy 1 11 11.0 11.0
90887 Interpretation of Psychiatric and Other medical Examination 4 4 4.0 1.0
90899 Unlisted Psychiatric Service 5 5 5.0 1.0
97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 12 1,464 16,798.0 1,399.8
97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 3 170 635.0 211.7
97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 11 663 4,385.0 398.6
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 7 65 175.0 25.0
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 24 35 35.0 1.5
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 15 28 28.0 1.9
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 17 1,199 1,225.0 72.1
H2012 Behavioral Health Day Treatment (General Day Treatment) 3 403 1,185.0 395.0
H2014 Skills Training 11 153 710.0 64.5
H2015 Crisis Assistance 1 1 4.0 4.0
H2019 Mental Health Behavioral Aide 0 0 0.0 0.0
T1013 Sign Language or Oral Interpreter Services 3 22 99.0 33.0
T1024 Evaluation and Treatment by Integrated, Specialty Team 10 207 207.0 20.7


Table 11b. PrimeWest: Types of treatment provided to children with ASD by category of service (n=194)

Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
54 Occupational Therapy 94 2,275 5,082 54.1
51 Physical Therapy 21 391 645.0 30.7
53 Speech Therapy 82 1,456 1,456.0 17.8


Table 12a. South Country Health Alliance: Types of treatment provided to children with ASD by procedure code (n=112)

Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
90832 Psychotherapy, 30 min 7 29 29.0 4.1
90833 Psychotherapy with E&M, 30 minutes 1 4 4.0 4.0
90834 Psychotherapy, 45 min 11 30 30.0 2.7
90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
90837 Psychotherapy, 60 min 15 123 123.0 8.2
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 12 41 41.0 3.4
90847 Family Psychotherapy - With Patient Present 5 17 17.0 3.4
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 4 5 5.0 1.3
97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 16 6,118 41,805.0 2,612.8
97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 7 141 344.0 49.1
97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 16 2,076 10,201.0 637.6
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 9 167 533.0 59.2
97157 Multiple Family Group Adaptive Behavior Treatment Guidance 2 2 4.0 2.0
99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
H0031 Administering and Reporting Standardized Measures 7 11 11.0 1.6
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 11 26 26.0 2.4
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 17 1,439 1,488.0 87.5
H2012 Behavioral Health Day Treatment (General Day Treatment) 2 164 487.0 243.5
H2014 Skills Training 8 204 1,030.0 128.8
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 15 224 224.0 14.9


Table 12b. South Country Health Alliance: Types of treatment provided to children with ASD by category of service (n=112)

Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
54 Occupational Therapy 33 512 1,184 35.9
51 Physical Therapy 8 77 171.0 21.4
53 Speech Therapy 48 890 891.0 18.6


Table 13a. UCare: Types of treatments provided to children with ASD by procedure code (n=1,826)

Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
90832 Psychotherapy, 30 min 88 218 218.0 2.5
90833 Psychotherapy with E&M, 30 minutes 17 42 42.0 2.5
90834 Psychotherapy, 45 min 107 635 635.0 5.9
90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
90837 Psychotherapy, 60 min 134 854 856.0 6.4
90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
90839 Psychotherapy for Crisis, first 60 minutes 1 2 2.0 2.0
90840 Psychotherapy for Crisis, over 74 minutes 1 1 1.0 1.0
90846 Family Psychotherapy - Without Patient Present 415 1,416 1,416.0 3.4
90847 Family Psychotherapy - With Patient Present 256 774 774.0 3.0
90849 Multiple Family Group Psychotherapy 14 118 118.0 8.4
90853 Group Psychotherapy 1 2 2.0 2.0
90887 Interpretation of Psychiatric and Other medical Examination 4 4 4.0 1.0
90899 Unlisted Psychiatric Service 34 73 75.0 2.2
97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 342 75,810 822,434.0 2,404.8
97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 75 8,563 28,098.0 374.6
97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 336 30,021 243,264.0 724.0
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 263 9,009 68,103.0 258.9
97157 Multiple Family Group Adaptive Behavior Treatment Guidance 1 1 16.0 16.0
99499 Unlisted Evaluation and Management Service 1 1 1.0 1.0
H0031 Administering and Reporting Standardized Measures 397 747 747.0 1.9
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 315 989 1,002.0 3.2
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 396 22,700 22,781.0 57.5
H2012 Behavioral Health Day Treatment (General Day Treatment) 180 18,246 46,852.0 260.3
H2014 Skills Training 100 3,013 53,188.0 531.9
H2015 Crisis Assistance 2 2 5.0 2.5
H2019 Mental Health Behavioral Aide 0 0 0.0 0.0
T1013 Sign Language or Oral Interpreter Services 431 4,456 16,536.0 38.4
T1024 Evaluation and Treatment by Integrated, Specialty Team 126 693 696.0 5.5


Table 13b. UCare: Types of treatments provided to children with ASD by category of service (n=1,826)

Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
54 Occupational Therapy 894 24,116 60,176 67.3
51 Physical Therapy 197 4,500 7,950.0 40.4
53 Speech Therapy 993 26,014 26,127.0 26.3


Table 14a. United Healthcare: Types of treatments provided to children with ASD by procedure code (n=115)

Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
90832 Psychotherapy, 30 min 3 16 16.0 5.3
90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
90834 Psychotherapy, 45 min 5 24 24.0 4.8
90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
90837 Psychotherapy, 60 min 6 11 11.0 1.8
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 25 65 65.0 2.6
90847 Family Psychotherapy - With Patient Present 11 27 27.0 2.5
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 3 22 22.0 7.3
97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 10 2,680 24,288.0 2,428.8
97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 6 896 2,954.0 492.3
97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 10 874 4,715.0 471.5
97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 10 159 563.0 56.3
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 32 44 44.0 1.4
H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 19 25 25.0 1.3
H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 14 599 610.0 43.6
H2012 Behavioral Health Day Treatment (General Day Treatment) 13 817 2,154.0 165.7
H2014 Skills Training 3 61 124.0 41.3
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 13 57 211.0 16.2
T1024 Evaluation and Treatment by Integrated, Specialty Team 7 20 20.0 2.9


Table 14b. United Healthcare: Types of treatments provided to children with ASD by category of service (n=115)

Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
54 Occupational Therapy 51 988 2,472 48.5
51 Physical Therapy 11 249 511.0 46.5
53 Speech Therapy 55 1,368 1,368.0 24.9


Notes

  • Data are limited to final version Minnesota Health Care Programs (MHCP) paid claims with service dates between Jan. 1 through Dec. 31, 2024, inclusive.
  • Analysis was limited to children enrolled in a managed care organization (MCO). 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 (FFS) for the most months during the year, then they were excluded from this analysis.
  • Only managed care claims were included in analysis.
  • Age was calculated as of Dec. 31, 2024.
  • Analysis was limited to children aged 1 through 6.
  • Diagnostic Assessments were identified using procedure codes 97151, 90791, 90792, 90785, 96101, 96102, 96103, 96116, 96118, 96119 and 90887.
  • Children with a diagnosis of autism spectrum disorder (ASD) were identified with claims having an ICD10CM diagnosis code of F84.0, F84.2, F84.3, F84.5, F84.8 or F84.9.
  • 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 T1024, T1027, H0032 , 99366, 97153, 97154, 97155, 97156, 97157 (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 the unique services for all the children in each respective MCO. These counts were deduplicated using standard DHS procedures.
  • All treatment claims were deduplicated using standard operating procedures.
  • Analysis was designed in adherence to Minn. Stat. 256B.69, subd. 32a. (see below).

Minn. Stat. 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.