CMS-approved state plan amendment – 2017 (PDF), CMS-approved state plan amendment – 2018 update (PDF), CMS-approved state plan amendment – 2019 update (PDF), Minn. Stat. §256B.0949

Every Early Intensive Developmental and Behavioral Intervention (EIDBI) service must address the person’s medically necessary treatment goals and be targeted to develop, enhance or maintain the person’s developmental skills to improve their:

Every EIDBI intervention service must:

The person must receive a CMDE to determine if they have a medical need for EIDBI services. They must have a completed CMDE Medical Necessity Summary Information, DHS-7108 signed and dated by the following people:

Once the person is determined eligible for EIDBI services, the provider agency develops an individualized treatment plan (ITP). Before the person can start or continue receiving services, they must have a completed ITP and Progress Monitoring, DHS-7109 signed and dated by the following people:

The signatures on DHS-7108 and DHS-7109 serve as consent for the person to begin or continue receiving EIDBI services. The signatures must meet the requirements on EIDBI – How to complete CMDE Medical Necessity Summary Information, DHS-7108 and EIDBI – How to complete ITP and Progress Monitoring, DHS-7109.

Note: Only people who can consent to treatment and make legal decisions can sign these forms. This may not include all caregivers. Providers must make sure the people who sign the forms have the legal authority to do so.

Person-centered planning ensures EIDBI services:

The EIDBI benefit covers the following services:

For more information, refer to the service-specific pages.

Telehealth services

A person may receive some EIDBI services via telehealth. For more information, refer to EIDBI – Telehealth services.

Simultaneous services

Multiple providers may deliver and bill for the following EIDBI services at the same time:

Multiple providers may deliver a combination of EIDBI services at the same time (e.g., one provider delivers individual intervention, and another provider delivers observation and direction) as medically necessary.

Continuous service delivery

EIDBI services must reflect continuous intervention, provider presence and purposeful therapeutic activity throughout the entire billable period. Providers may only bill for time during which qualified providers actively deliver medically necessary EIDBI services according to the person’s CMDE and ITP.

The person may receive EIDBI services in the following settings:

For more information, including setting definitions and documentation requirements, refer to EIDBI – Settings for EIDBI services.

The person’s EIDBI services must coordinate with educational/academic services to ensure the person receives the most appropriate and effective combination of services to meet their needs.

EIDBI provider agencies and individual EIDBI providers must:

The person may receive EIDBI services during school hours, on school grounds or in homeschool or virtual school environments when the services are medically necessary and clearly documented in the person’s ITP, including the reason and specific goals and objectives. For more information, refer to:

Homeschool or virtual school instruction

When a child is assigned to or participates in homeschool or virtual school instruction, the family and school are responsible for fulfilling all educational and instructional requirements under state and federal law.

EIDBI providers must not intentionally or unintentionally overstep or replace the role of the teacher, paraprofessional or family to deliver educational services.

EIDBI providers must ensure that EIDBI services:

Non-covered services during homeschool or virtual school instruction

Effective Jan. 1, 2026, EIDBI providers must not deliver or bill the following direct intervention services during homeschool or online/virtual school instruction:

Covered services during homeschool or virtual instruction

Providers may deliver family/caregiver training (i.e., 97156) if the parent or caregiver is available and participates. This allows medically necessary support to continue while protecting the person’s right to a free and appropriate public education (FAPE).

Progress monitoring, supervision and care coordination

Providers may deliver progress monitoring, staff supervision and care coordination activities in coordination with educational/academic services as medically necessary to support the person’s treatment goals. Providers should:

Documentation requirements

Data collection and notes should not describe or track:

Documentation must:

For more information about case notes, refer to the case notes section of EIDBI – Health service records.

The person’s EIDBI services must coordinate with other Medicaid funded services to ensure the person receives the most appropriate and effective combination of services to meet their needs.

The person may receive EIDBI services in coordination with other Medicaid-funded services, including but not limited to:

The following EIDBI services are allowable in a PRTF:

EIDBI and HCBS service coordination

The person can receive EIDBI and HCBS waiver services either concurrently (i.e., during the same service period but not at the same time) or simultaneously (i.e., during the same service period and at the same time) if medically necessary. This includes, but is not limited to:

For more information, refer to the applicable pages in this manual and the Community-Based Services Manual (CBSM).

Requirements for coordination with other services

EIDBI provider agencies are responsible to:

The EIDBI benefit does not cover:

1. Provider training, supervision or observation activities that do not meet covered service criteria, including:

2. Transportation for the person.

3. Services conducted via mail or email.

4. Administrative tasks and program development activities, including:

5. Services that are not documented in the person’s health service record or ITP in the manner outlined in this manual or Minn. R. 9505.2175.

6. Services that are primarily for custodial, day care or respite purposes (e.g., diapering, toileting, feeding, dressing, hygiene support) that are not implemented as skill-building intervention within the ITP.

7. Services that are primarily recreational and not supervised by a medical professional (e.g., sports activities, craft activities, meal/snack time, trips to community activities, tours).
Note: EIDBI may cover these activities if they are primarily for treatment and provided according to the person’s ITP.

8. Services that are the responsibility of a residential or program license holder (e.g., foster care provider) according to a service agreement (SA) or administrative licensing rules.

9. Services not approved by DHS’ medical review agent, except for services that do not require authorization.

10. Services that include or replace academic goals that are otherwise included in the person’s Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP), as required under the Individuals with Disabilities Education Improvement Act of 2004 (IDEA).

11. Services provided by:

12. Services provided in the following circumstances:

13. Services not provided (e.g., late to appointments, appointment no-shows).

14. Waiting or idle time, including:

15. Services not provided directly to a person who is present either physically or via interactive video, except the following services that do not require the person to be present:

16. Provider breaks of any kind, including:

Note: Providers must pause billing for the duration of the break. They may not bill for any time in which they are not physically present and actively engaged in EIDBI service delivery.

17. Facility preparation or cleanup, including time to:

18. Technology, billing, electronic health record or administrative system tasks, including:

Families have the right to transfer or change EIDBI provider agencies for any reason.

New agency’s responsibilities

The new agency is responsible to work with the family to gather discharge information from the previous agency. When a family chooses to transfer or a provider recommends a transfer, the new agency should ask the family to sign a release of information form to gather previous records. The new agency can use either General Consent/Authorization for Release of Information, DHS-3549 (PDF) or an agency-developed release form.

The new agency should review the records and determine if the person’s previous CMDE and ITP are still valid. If the CMDE is still valid, the new agency may use the CMDE to determine medical necessity. The new agency must update the ITP with its information but may reference the previous ITP.

The new agency should complete a CMDE and ITP, as instructed on EIDBI – How to complete CMDE Medical Necessity Summary Information, DHS-7108 and EIDBI – How to complete ITP and Progress Monitoring, DHS-7109, in any of the following situations:

If the person has already used the set number of CMDE units, the new agency may submit EIDBI Authorization Request, DHS-3806 to request authorization of additional services beyond the service limit threshold.

For service authorization instructions, billing limits and additional information, refer to MHCP Provider Manual – EIDBI benefit.

For EIDBI agency contact information, refer to DHS – MHCP Provider Directory.

At the time of the authorization request, the new agency must make sure the previous agency has either:

If the new agency does not have the above information, DHS’ medical review agent will reject the request. DHS’ medical review agent will only approve EIDBI services after the discharge date if they determine the transition is medically necessary.

Previous agency’s responsibilities

The previous agency should provide the new agency with all the following information:

The previous agency should notify DHS’ medical review agent and request to end the person’s service authorization, effective on the date of discharge. This will prevent SA overlap and denial of authorization requests.

Providers must follow EIDBI policy, as described throughout the EIDBI Policy Manual, and consult with the person’s caregiver/guardian about the transition plan.

Completing DHS-7109A

When the person transfers agencies, the QSP at the previous agency should download and complete EIDBI transition and/or discharge summary, DHS-7109A electronically. For more information, including instructions to complete the form, refer to the DHS-7109A section on EIDBI – How to complete ITP and Progress Monitoring, DHS-7109.

For additional information and instructions, refer to MHCP Provider Manual – Service authorization.

The EIDBI provider agency may terminate the person’s EIDBI services if they meet one of the medical necessity termination criteria.

The provider must send notice of termination to the person or their legal representative. The transition period begins when the person or their legal representative receives notice of termination and ends on the last date of EIDBI services. DHS allows up to 30 days of continued service during the transition period. Services during the transition period must be consistent with services documented in the ITP (refer to EIDBI – How to complete ITP and Progress Monitoring, DHS-7109).

Transition plan

The transition plan, documented in the person’s ITP, must include:

Completing DHS-7109A

When the provider agency terminates services, the QSP should download and complete EIDBI transition and/or discharge summary, DHS-7109A electronically. For more information, including instructions to complete the form, refer to the DHS-7109A section on EIDBI – How to complete ITP and Progress Monitoring, DHS-7109.

Note: DHS-7109A is separate from the transition plan documented in the person’s ITP.