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

Page posted: 2/17/17

Page reviewed: 11/21/17

Page updated: 11/21/17

Legal authority

Minn. Stat. §256B.0949; Minn. Stat. §256B.0625, subd. 3b; Minn. Stat. 245.462, subd. 17; Minn. Stat. 245.4871, subd. 26; Health Insurance Portability and Accountability Act (HIPPA) Privacy and Security Rules

Definitions

Telemedicine: Delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site.

Background

As of Jan. 1, 2016, Medical Assistance (MA) covers medically necessary telemedicine services and consultations. The telemedicine services and consultations must be provided with the same service thresholds, authorization requirements and reimbursement rates as services delivered face-to-face.

Because Early Intensive Developmental and Behavioral Intervention (EIDBI) is a benefit available under MA, telemedicine is an option for some EIDBI services.

Coverage for fee-for-service and MCO

If the person is fee-for-service, he or she can receive eligible EIBDI telemedicine services. Managed care organizations (MCO) may or may not choose to pay for telemedicine services. If the person receives services through an MCO, consult the MCO to confirm coverage for telemedicine services.

Eligible providers

If they are enrolled with MHCP as EIDBI providers, the following provider types can deliver and bill for EIDBI telemedicine services:

  • • Physician
  • • Nurse practitioner
  • • Clinical psychologist
  • • Clinical social worker
  • • Speech therapist
  • • Physical therapist
  • • Occupational therapist.
  • In addition, as of July 1, 2017, MA also covers medically necessary services and consultation by a mental health practitioner (as defined by section Minn. Stat. §245.462, subd. 17 or Minn. Stat. §245.4871, subd. 26) working under the general supervision of a mental health professional.

    A comprehensive multi-disciplinary evaluation (CMDE) provider, qualified supervising professional (QSP), Level I or Level II EIDBI provider may apply to provide EIDBI services via telemedicine if they meet the qualifications and complete the Telemedicine Assurance statement. For additional information, see MHCP EIDBI Provider Enrollment – Telemedicine.

    Other provider types may deliver and bill for telemedicine services. For a complete list, see MHCP – Physician and professional services – Telemedicine.

    Covered EIDBI services

    An eligible EIDBI provider may deliver the following EIDBI services via telemedicine:

    Non-covered EIDBI services

    MHCP does not reimburse for connection charges or origination, set-up or site fees.

    Requirements

    EIDBI telemedicine services must be:

  • • Documented in the person’s individual treatment plan (ITP)
  • • Compliant with Health Insurance Portability and Accountability Act (HIPAA) privacy and security requirements and regulations
  • • Medically appropriate to the condition and needs of the person and/or family.
  • Either the person or his/her family must be present via two-way, interactive video while the provider delivers EIDBI telemedicine services.

    For other telemedicine requirements providers must meet, see MHCP – Physician and professional services – telemedicine.

    Service authorization and billing

    EIDBI telemedicine services and consultations must be provided with the same service thresholds, authorization requirements and reimbursement rates as services delivered face-to-face.

    Coverage is limited to three telemedicine services per recipient, per calendar week.

    For authorization and billing information, including provider and service limits, see:

    Additional resources

    EIDBI – EIDBI services
    MHCP Provider Manual – Physician and professional services – telemedicine

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    © 2018 Minnesota Department of Human Services Updated: 11/21/17 9:38 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 11/21/17 9:38 AM