Page reviewed: 11/4/26

Page updated: 11/4/26

Legal authority

Minn. Stat. §256B.0949, Minn. Stat. §245I.10, subd. 6

Definitions

Autism spectrum disorder (ASD): A neurodevelopmental condition characterized by differences in social communication and interaction, along with restricted or repetitive behaviors, interests or activities. Characteristics and support needs vary from person to person. For a full definition of ASD, refer to the current version of the American Psychiatric Association (APA) – Diagnostic and Statistical Manual of Mental Disorders (DSM).

Related condition: A condition that is closely related to ASD and:

1. Is severe and chronic.

2. Results in impairment of a person’s adaptive behavior and function, like that of a person with ASD.

3. Requires treatment or services, like those required for a person with ASD.

4. Results in functional limitations in three core developmental areas of ASD:

5. May include delays or need a high level of support in one or more of the following domains:

Eligibility criteria

A person is eligible to receive Early Intensive Developmental and Behavioral Intervention (EIDBI) services if they meet all the following criteria:

A Minnesota Health Care Programs (MHCP)-enrolled CMDE provider determines whether a person meets these eligibility criteria during the CMDE process.

Diagnosis

A diagnosis of ASD or a related condition for the purposes of EIDBI services must:

Using DSM versus DC:0-5

When completing a standard diagnostic assessment, the CMDE provider must use DSM or DC: 0-5 based on the person’s age as follows:

Diagnostic assessment tools

The CMDE provider must use clinically appropriate, evidence-based diagnostic assessment tools to determine the diagnosis. The CMDE provider should select assessment methods based on the person’s:

ASD evaluation

When evaluating for ASD, the CMDE provider should use one or more of the following standardized autism-specific assessment methods:

Related condition evaluation

When evaluating for a related condition, the CMDE provider should use appropriate standardized assessment methods. The CMDE provider may review and incorporate relevant existing evaluations completed by licensed school personnel or other licensed professionals. Existing evaluations may supplement but not replace the CMDE provider’s independent evaluation and clinical determination.

Functional and developmental assessment tools

In addition to using the diagnostic assessment tools described above to determine a qualifying diagnosis, the CMDE provider must:

Functional and developmental assessment tools may include standardized measures of:

Note: Eligibility for certain MA programs, case management services or home and community-based services (HCBS) waiver programs may require intellectual functioning (IQ) and adaptive behavior assessments. For more information, refer to EIDBI – EIDBI services – Coordination with other services.

CMDE

A CMDE is a covered EIDBI service used to determine a person’s medical need and eligibility for EIDBI services. For more information about the CMDE and medical necessity determination process, refer to:

ITP development and progress monitoring

ITP development and progress monitoring is a covered EIDBI service that uses the findings and recommendations from the CMDE to develop the person’s ITP and monitor progress over time.

A person remains eligible for EIDBI services when they continue to:

For more information, refer to EIDBI – ITP development and progress monitoring.

Transition, discharge and termination from EIDBI services

If the person meets criteria for medically necessary termination:

Additional resources

APA – DSM
EIDBI – CMDE
EIDBI – ITP development and progress monitoring
EIDBI – EIDBI services
EIDBI – Medical necessity criteria
EIDBI – Overview of EIDBI providers
EIDBI Referral Form, DHS-6751S
Minnesota Autism Resource Portal – Screening and identification
Minnesota Autism Resource Portal – Signs and characteristics
Zero to Three