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Minnesota Department of Human Services Early Intensive Development and Behavioral Intervention Manual
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EIDBI services

Page posted: 6/15/15

Page reviewed: 2/17/17

Page updated: 2/17/17

Legal authority

CMS-approved EIDBI state plan amendment (PDF), Minn. Stat. §256B.0949

Overview

Every Early Intensive Developmental and Behavioral Intervention (EIDBI) service must be targeted to develop, enhance, and maintain the person’s developmental skills in order to improve his or her:

  • • Behavioral challenges and self-regulation
  • • Cognition
  • • Functional communication
  • • Learning and play
  • • Needed level of support
  • • Safety
  • • Self-care
  • • Social or interpersonal interaction.
  • Every EIDBI service also must:

  • • Address the person’s medically necessary treatment goals
  • • Be provided by a qualified EIDBI provider and supervised by a qualified supervising professional (QSP)
  • • Meet DHS billing requirements.
  • Covered services

    The EIDBI Benefit covers the following services:

    For more information, see each service-specific page.

    Telemedicine

    A person may receive some EIDBI services via telemedicine. For more information, see EIDBI – Telemedicine services.

    Settings

    A person may receive EIDBI services in:

  • • Center
  • • Clinic
  • • Community environment
  • • His or her home
  • • Office.
  • For more information, including setting definitions and documentation requirements, see EIDBI – Settings for EIDBI services.

    Coordination with other services

    A person’s EIDBI services must coordinate with all other services he or she receives to ensure he or she recieves the most appropriate and effective combination to meet his or her needs.

    Educational/academic services

    EIDBI services are not intended to replace educational or academic services. EIDBI provider agencies and individual EIDBI providers must:

  • • Coordinate a person’s EIDBI services with all educational/academic services he or she recieves or is eligible to receive
  • • Not represent EIDBI services as educational or academic services.
  • This does not prevent a person from receiving EIDBI services during school hours or on school grounds. However, if a person does receive EIDBI services during school hours or on school grounds, the person’s ITP must document why, including specific goals and objectives. For more information, see:

    Other Medicaid-funded services

    A person may receive EIDBI services in conjunction with other Medicaid-funded services, such as:

  • • Home and community-based services (HCBS) waivers
  • • Home care (including personal care assistance (PCA))
  • • Mental health services (including Children’s Therepeutic Services and Supports (CTSS))
  • • Occupational therapy
  • • Speech therapy.
  • Non-covered services

    The EIDBI Benefit does not cover services that are:

  • • Conducted over the telephone, or via mail or email
  • • For the purpose of reporting, charting or record keeping (except when this is integral to a covered CMDE or ITP service)
  • • Not documented in the person’s health service record or ITP in the manner outlined by this policy manual or Minn. R. Part 9505.2175
  • • Primarily custodial, day care or respite
  • • Primarily recreational and not supervised by a medical professional, e.g., sports activities, craft activities, meal/snack time, trips to community activities tours, etc. (These activities may be covered if they are primarily for treatment and provided according to the person’s ITP.)
  • • The responsibility of a residential or program license holder (e.g., foster care providers) according to a service agreement or administrative licensing rules.
  • The EIDBI Benefit does not cover services that:

  • • Have not been approved by the state’s medical review agent (except for services that do not require authorization)
  • • Include or replace academic goals that are otherwise included in the person’s Individual Education Plan (IEP) or Individual Family Service Plan (FSP), as required under the Individual with Disabilities Education Improvement Act of 2004.
  • The EIDBI Benefit does not cover services that are provided:

  • • By a parent, legal guardian or another person legally responsible for the person
  • • By a person who does not meet the provider qualifications
  • • In violation of Medical Assistance (MA) policy as outlined in Minn. R, 9505.0220
  • • To the general community (e.g., prevention and education programs)
  • • When the person is sleeping or napping
  • • Without the required supervision.
  • The EIDBI Benefit also does not cover services that are not provided (e.g., appointment no-shows) or not provided directly to a person who is present, either physically or via interactive video. Exception: The following services do not require the person to be present:

  • • Coordinated care conference
  • • Family/caregiver training and counseling
  • • ITP development.
  • The EIDBI Benefit does not cover:

  • • Provider training activities that do not meet the criteria for observation and direction
  • • Transportation for the person
  • Intervention services delivered to one person by two or more EIDBI providers (of any level) at the same time.
  • Termination of services

    The EIDBI provider agency may terminate a person’s EIDBI services if one of the medical necessity criteria is met for termination of EIDBI services.

    The EIDBI provider agency should include the person’s parent/legal guardian’s input in the decision to terminate EIDBI services and document its rationale for termination in the ITP.

    Before terminating EIDBI services, the provider agency should notify to the person’s legal guardian.

    Additional resources

    EIDBI – Eligibility for EIDBI services
    EIDBI – Medical necessity criteria

    MHCP Provider Manual – EIDBI – billing

    MHCP Provider Manual – EIDBI – service authorization

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    © 2017 Minnesota Department of Human Services Updated: 3/29/17 4:48 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 3/29/17 4:48 PM