Assistive Technology (AT) Devices

Revised: December 13, 2024

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· Overview

· Authorization and Orders

· Covered Services

· Coverage Criteria

· Noncovered Services

· Health Records and Documentation

· Required Documentation for Electronic Claim Attachments

· Billing

· Legal References

Overview

Minnesota Health Care Programs (MHCP) will cover Individualized Education Program (IEP) health-related assistive technology (AT) devices and equipment for MHCP-eligible children when identified in a child’s IEP or Individualized Family Service Plan (IFSP) and covered under Medical Assistance (Minnesota’s Medicaid program).

When all coverage criteria are met, MHCP will pay the federal share of the cost of the item and the school will be responsible for the non-federal share.

If all coverage criteria are not met, the school is responsible for 100 percent of the cost.

Authorization and Orders

The IEP team authorizes services included in an IEP or IFSP. A signature of a physician, advanced practice registered nurse (APRN), nurse practitioner or physician assistant is not required for approval of the IEP or IFSP or for assistive technology devices. The IEP team determines the need for IEP services.

Note: Only a speech-language pathologist is responsible for ordering communication devices, including dedicated electronic devices, once the order is approved by the IEP team.

Covered Services

· Hearing amplification devices – for example, FM systems

· Dedicated speech generating devices (“locked” for a specific use or purpose)

· Augumentative Communication (AC) Devices and Tablets are those designed, trademarked and supplied by the individual manufacturer

· Non-dedicated tablet – For the purpose of this policy, this refers to any electronic tablet designed for multipurpose use and sold (provided) by manufacturers, retailers and suppliers. Examples of these tablets include Apple iPad® or Samsung Galaxy®. To be covered under MHCP, these tablets must be locked to prevent use other than communication. When locked, these tablets ware considered “dedicated,” and are eligible for coverage.

· Communication picture books

· Communication charts and boards

· Mechanical devices

· Electronic devices

· Electronic tablets

· Communication software application

· Carrying cases or mounting

· Other accessories that are medically necessary

· Mobility devices – for example, wheelchairs, walkers

· Positioning devices – for example, standing boards

MHCP will cover only one same or similar device, except when the item is too cumbersome or hard to transport. Items too cumbersome to transport may include a stander, Hoyer lift and certain toilet seats.

Equipment purchased with any Medicaid funds belongs to the child.

Coverage Criteria

To be covered, the AT device or equipment must be:

· Medically necessary – the child has a condition that requires use of the device.

· Identified in the IEP or IFSP dated before the date of service or purchase.

· Documented assessments and trial notes dated before the date of service or purchase if the equipment needed is one of the following:

· FM systems

· Augmentative Communication (AC) devices

· Rented, repaired or purchased for an eligible child who receives services provided under an IEP or IFSP.

· Used only by the child for whom the device is purchased or rented.

· Used as needed in the school, home and community.

Refer to the Covered and Noncovered IEP Health-Related Services section for an overview of covered services and coverage criteria for all IEP services.

Noncovered Services

The following list of noncovered services is not all-inclusive:

· Accessories, add-ons and upgrades to noncovered devices

· Air Conditioners

· Alert systems

· Any equipment used only for education purposes, or purchased for the school

· Cervical roll, pillow

· Changing tables

· Devices or equipment used only for educational purposes

· Electronic devices that are not dedicated communication devices

· Environmental control devices such as switches, control boxes or battery interrupters.

· Evacuation chairs

· Exercise equipment or bicycles

· Facilitated communication; services of an assistive technology specialist

· Laptops

· Motorized lifts

· Modifications, construction, programming or adaptations of communication systems

· Medical response systems

· Personal computers, laptop computers, and other personal media players that are not dedicated communication devices

· Repairing and or cleaning non-covered devices

· Replacing devices based on manufacturer’s recommended replacement schedule; for example, every 5 years

· Shipping, freight and handling charges

· Speech-generating devices and FM systems used for education purposes

· Tape recorders

· Telephones and telephone answering machines

· Toys and instructional materials

· Upgrading to new technology that is not proven to be medically necessary

· Used equipment,

· Video recorders

· Warranties, extended warranties or service agreements

Refer to the Covered and Noncovered IEP Health-Related Services section for an overview of the covered and noncovered IEP Health-Related Services.

Health Records and Documentation

Required documentation for AT devices:

· Medical diagnosis and condition that supports the medical need

· Results of tests and assessments or evaluations

· A copy of the IEP or IFSP that includes the reasons why the child needs the device, and any additional components, accessories or mounts that are needed beyond the accessories that come with the initial purchase of the device.

· Warranty information for the item when a warranty is available (some items have warranties, some items do not)

· Copies of invoices or rental agreements for hardware and software essential to the device

· Copies of assessments or trials performed to determine the need and usefulness specific to the child

Required Documentation for Electronic Claim Attachments

Payment rates for AT devices are based on the actual costs of the device. MHCP will pay the federal share of the invoiced price, the rental costs, or cost of repairs of the DHS approved AT devices. Currently, the federal share is 50 percent. Schools must send an electronic claim attachment providing documentation to identify the child’s need, the item(s) provided to the child, and the cost.

When sending documentation include:

· AUC Cover Sheet for Health Care Claim Attachments

· A copy of the current IEP plan or pages that indicate the child’s need for the device, accessory, software, mounts or other hardware or equipment needed to make the device operational and useful for the child

· Copies of the therapist assessment of the child’s needs, when applicable

· An itemized list of all purchases, repair items or rental needs for this device, including the manufacturer, item number and description

· Copy of the invoices for each device, accessory, software application, mounts or other hardware for the equipment purchased, needed as part of the repair or rental

· Copies of the warranty or other documentation from the vendor, showing the length of the warranty and if the warranty period has expired, when applicable

Billing

Submit claims using the 837P Professional clam type. Refer to the Billing for IEP Services section of the MN–ITS User Manual for step-by-step instructions for direct data entry claims. Batch billers submitting X12 837P claims may review the MHCP 5010/D.0 compliance Web page and the AUC Minnesota Uniform Companion Guides for transaction guideline.

· Do not submit claims for AT devices and accessories until the child has received the device

· Use CPT code T1018 modifier U7 also in addition to the U7 modifier also add one of the following modifiers to further identify the service:

· NU if the claim is for a new device

· RR if rented

· RB for repairs

· RA if replacing an existing device

Note: Review the IEP Billing and Authorization Requirements section for basic requirements.

Legal References

Minnesota Statue 256B.0625, subdivision 26 (Covered Services – Special education services)