Page posted: 6/15/15
Page reviewed: 7/20/18
Page updated: 7/20/18
Every Early Intensive Developmental and Behavioral Intervention (EIDBI) service must both address the person’s medically necessary treatment goals and be targeted to develop, enhance or maintain the person’s developmental skills to improve his or her:
Every EIDBI service also must:
Person-centered planning ensures EIDBI covered services:
The EIDBI benefit covers the following services:
For more information, see each service-specific page.
A person may receive some EIDBI services via telemedicine. For more information, see EIDBI – Telemedicine services.
More than one provider may bill for these services at the same time:
Different levels of EIDBI providers may bill for these services at the same time:
A person may receive EIDBI services in the following settings:
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/she receives to ensure he/she receives the most appropriate and effective combination to meet his/her needs.
EIDBI services are not intended to replace educational or academic services. EIDBI provider agencies and individual EIDBI providers must:
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, including, but not limited to:
The EIDBI benefit does not cover:
The EIDBI benefit does not cover services that are:
1. Conducted over the telephone, or via mail or email
2. For the purpose of reporting, charting or record-keeping (except when this is integral to a covered CMDE or ITP service or a health service record)
3. Not documented in the person’s health service record or ITP in the manner outlined by this policy manual or Minn. R. 9505.2175
4. Primarily custodial, day care or respite
5. Primarily recreational and not supervised by a medical professional (e.g., sports activities, craft activities, meal/snack time, trips to community activities tours, etc.)
6. The responsibility of a residential or program license holder (e.g., foster care providers) according to a service agreement or administrative licensing rules
7. Not approved by the state’s medical review agent (except for services that do not require authorization)
8. Including or replacing academic goals that are otherwise included in the person’s Individual Education Plan (IEP) or Individual Family Service Plan (FSP), as required under the Individuals with Disabilities Education Improvement Act of 2004
9. Provided by:
10. Provided in the following circumstances:
11. Not provided (e.g., appointment no-shows)
12. Not provided directly to a person who is present either physically or via interactive video, with the exception of the following services that do not require the person to be present:
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 provider must send notice of termination to the person or the person’s legal representative. The transition period begins when the person or the person’s legal representative receives notice of termination and ends on the last date of EIDBI services. Up to 30 days of continued service is allowed during the transition period. Services during the transition period must be consistent with what is documented in the ITP (see EIDBI – How to complete ITP and Progress Monitoring, DHS-7109).
The transition plan, documented in the person’s ITP, must include: