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    Data from 2019 calendar year

    Table 1. Number of children (1-6 years old) who received a diagnostic assessment

    MCO Number of children (ages 1 - 3) Number of children (ages 4 - 6)
    Blue Plus 577 2,392
    HealthPartners 229 954
    Hennepin Health 13 59
    Itasca Medical Care 12 81
    Medica 0 0
    PrimeWest 63 303
    South Country Health Alliance 66 290
    UCare 427 1,486
    MCOs overall 1,387 5,565


    Table 2. Number of children (1-6 years old) with a diagnosis of autism spectrum disorder (ASD) who received treatments

    MCO Number of children with ASD Number of children with treatment(s)
    Blue Plus 956 735
    HealthPartners 417 333
    Hennepin Health 27 21
    Itasca Medical Care 16 14
    Medica 0 0
    PrimeWest 122 95
    South Country Health Alliance 92 67
    UCare 849 679
    MCOs Overall 2,479 1,944


    Table 3a. Number of children (1-3 years old) with a diagnosis of ASD who received treatments, by MCO and age

    MCO # 1-year-old children with ASD # 1-year-olds receiving treatments # 2-year-old children with ASD # 2-year-olds receiving treatments # 3-year-old children with ASD # 3-year-olds receiving treatments
    Blue Plus 10 5 75 64 187 145
    HealthPartners 1 1 33 28 75 65
    Hennepin Health 0 0 2 2 9 6
    Itasca Medical Care 1 1 2 2 2 1
    Medica 0 0 0 0 0 0
    PrimeWest 2 1 7 4 20 18
    South Country Health Alliance 1 0 3 3 12 11
    UCare 8 6 97 80 186 164
    MHCP Overall 23 14 219 183 491 410


    Table 3b. Number of children (4-6 years old) with a diagnosis of ASD who received treatments, by MCO and age

    MCO # 4-year-old children with ASD # 4-year-olds who receive treatments # 5-year-old children with ASD # 5-year-olds who receive treatments # 6-year-old children with ASD # 6-year-olds who receive treatments
    Blue Plus 246 206 226 167 212 148
    HealthPartners 105 88 115 89 88 62
    Hennepin Health 7 7 5 3 4 3
    Itasca Medical Care 5 5 1 0 5 5
    Medica 0 0 0 0 0 0
    PrimeWest 21 16 36 32 36 24
    South Country Health Alliance 24 16 27 19 25 18
    UCare 207 170 181 138 170 121
    MHCP overall 615 508 591 448 540 381


    Table 4a. Blue Plus: Types of treatments provided to children with ASD by procedure code (n=956)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    0359T Comprehensive Multi-Disciplinary Evaluation (CMDE) 0 0 0.0 0.0
    0362T EIDBI Intervention Observation and Direction, first 30 minutes 0 0 0.0 0.0
    0363T EIDBI Intervention Observation and Direction, additional 30 minutes 0 0 0.0 0.0
    0364T EIDBI Intervention - Individual, first 30 minutes 0 0 0.0 0.0
    0365T EIDBI Intervention - Individual, additional 30 minutes 0 0 0.0 0.0
    0366T EIDBI Intervention - Group, first 30 minutes 0 0 0.0 0.0
    0367T EIDBI Intervention - Group, additional 30 minutes 0 0 0.0 0.0
    0368T EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes 0 0 0.0 0.0
    0369T EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes 0 0 0.0 0.0
    90832 Psychotherapy, 30 min 46 140 140.0 3.0
    90833 Psychotherapy with E&M, 30 minutes 15 37 37.0 2.5
    90834 Psychotherapy, 45 min 103 510 510.0 5.0
    90836 Psychotherapy with E&M, 45 min 2 4 4.0 2.0
    90837 Psychotherapy, 60 min 161 1,207 1,207.0 7.5
    90838 Psychotherapy with E&M, 60 min 4 4 4.0 1.0
    90839 Psychotherapy for Crisis, first 60 minutes 6 11 12.0 2.0
    90840 Psychotherapy for Crisis, additional 30 minutes 5 5 10.0 0.0
    90846 Family Psychotherapy - Without Patient Present 174 702 702.0 4.0
    90847 Family Psychotherapy - With Patient Present 215 1,154 1,154.0 5.4
    90849 Multiple Family Group Psychotherapy 3 5 5.0 0.0
    90853 Group Psychotherapy 2 14 14.0 7.0
    90875 Biofeedback Training 0 0 0.0 0.0
    90882 Environmental Intervention 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 14 15 15.0 1.1
    90899 Unlisted Psychiatric Service 39 130 130.0 3.3
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 0 0 0.0 0.0
    97151 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 47 146 776.0 16.5
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 42 4,945 60,748.0 1,446.4
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 19 515 2,120.0 111.6
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 40 1,105 7,242.0 181.1
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 32 212 830.0 25.9
    97157 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 1 3 10.0 10.0
    99366 Coordinated Care Conference: Medical Team Conference 9 12 12.0 1.3
    H0031 Administering and Reporting Standardized Measures 257 645 649.0 2.5
    H0032 Individual Treatment Plan Development and Monitoring 144 1,459 1,598.0 11.1
    H2012 Behavioral Health Day Treatment (General Day Treatment) 99 9,864 29,372.0 296.7
    H2014 Skills Training 115 4,585 53,474.0 465.0
    H2015 Crisis Assistance 3 3 5.0 1.7
    H2019 Mental Health Behavioral Aide 20 1,274 16,080.0 804.0
    T1013 Sign Language or Oral Interpreter Services 94 800 2,989.0 31.8
    T1018 School-based IEP Services, Bundled 0 0 0.0 0.0
    T1024 EIDBI Coordinated Care Conference 0 0 0.0 0.0
    T1027 Family/Caregiver Training and Counseling 0 0 0.0 0.0


    Table 4b. Blue Plus: Types of treatments provided to children with ASD by category of service (n=956)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 118 2348 4358 36.9
    053 Speech Therapy 494 11659 11659 23.6
    054 Occupational Therapy 474 11712 29238 61.7


    Table 5a. HealthPartners: Types of treatment provided to children with ASD by procedure code (n=417)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    0359T Comprehensive Multi-Disciplinary Evaluation (CMDE) 0 0 0.0 0.0
    0362T EIDBI Intervention Observation and Direction, first 30 minutes 0 0 0.0 0.0
    0363T EIDBI Intervention Observation and Direction, additional 30 minutes 0 0 0.0 0.0
    0364T EIDBI Intervention - Individual, first 30 minutes 0 0 0.0 0.0
    0365T EIDBI Intervention - Individual, additional 30 minutes 0 0 0.0 0.0
    0366T EIDBI Intervention - Group, first 30 minutes 0 0 0.0 0.0
    0367T EIDBI Intervention - Group, additional 30 minutes 0 0 0.0 0.0
    0368T EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes 0 0 0.0 0.0
    0369T EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes 0 0 0.0 0.0
    90832 Psychotherapy, 30 min 11 36 36.0 3.3
    90833 Psychotherapy with E&M, 30 minutes 5 8 8.0 1.6
    90834 Psychotherapy, 45 min 44 174 174.0 4.0
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 58 425 425.0 7.3
    90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 1 1 1.0 1.0
    90840 Psychotherapy for Crisis, additional 30 minutes 0 0 0.0 0.0
    90846 Family Psychotherapy - Without Patient Present 128 690 690.0 5.4
    90847 Family Psychotherapy - With Patient Present 128 545 545.0 4.3
    90849 Multiple Family Group Psychotherapy 2 7 7.0 0.0
    90853 Group Psychotherapy 2 18 18.0 9.0
    90875 Biofeedback Training 0 0 0.0 0.0
    90882 Environmental Intervention 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 2 5 5.0 2.5
    90899 Unlisted Psychiatric Service 11 42 42.0 3.8
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 0 0 0.0 0.0
    97151 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 6 54 201.0 33.5
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 5 794 10,957.0 2,191.4
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 2 32 176.0 88.0
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 5 167 1,185.0 237.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 3 30 113.0 37.7
    97157 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 0 0 0.0 0.0
    99366 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 142 365 365.0 2.6
    H0032 Individual Treatment Plan Development and Monitoring 40 535 623.0 15.6
    H2012 Behavioral Health Day Treatment (General Day Treatment) 80 8,626 26,333.0 329.2
    H2014 Skills Training 29 1,047 12,298.0 424.1
    H2015 Crisis Assistance 0 0 0.0 0.0
    H2019 Mental Health Behavioral Aide 8 318 4,322.0 540.3
    T1013 Sign Language or Oral Interpreter Services 58 1,035 4,864.0 83.9
    T1018 School-based IEP Services, Bundled 0 0 0.0 0.0
    T1024 EIDBI Coordinated Care Conference 0 0 0.0 0.0
    T1027 Family/Caregiver Training and Counseling 0 0 0.0 0.0


    Table 5b. HealthPartners: Types of treatment provided to children with ASD by category of service (n=417)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 41 968 1591 38.8
    053 Speech Therapy 255 6141 6143 24.1
    054 Occupational Therapy 238 5556 15652 65.8


    Table 6a. Hennepin Health: Types of treatment provided to children with ASD by procedure code (n=27)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    0359T Comprehensive Multi-Disciplinary Evaluation (CMDE) 0 0 0.0 0.0
    0362T EIDBI Intervention Observation and Direction, first 30 minutes 0 0 0.0 0.0
    0363T EIDBI Intervention Observation and Direction, additional 30 minutes 0 0 0.0 0.0
    0364T EIDBI Intervention - Individual, first 30 minutes 0 0 0.0 0.0
    0365T EIDBI Intervention - Individual, additional 30 minutes 0 0 0.0 0.0
    0366T EIDBI Intervention - Group, first 30 minutes 0 0 0.0 0.0
    0367T EIDBI Intervention - Group, additional 30 minutes 0 0 0.0 0.0
    0368T EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes 0 0 0.0 0.0
    0369T EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes 0 0 0.0 0.0
    90832 Psychotherapy, 30 min 0 0 0.0 0.0
    90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
    90834 Psychotherapy, 45 min 1 3 3.0 3.0
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 2 3 3.0 1.5
    90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 0 0 0.0 0.0
    90840 Psychotherapy for Crisis, additional 30 minutes 0 0 0.0 0.0
    90846 Family Psychotherapy - Without Patient Present 11 50 50.0 4.5
    90847 Family Psychotherapy - With Patient Present 12 98 98.0 8.2
    90849 Multiple Family Group Psychotherapy 1 18 18.0 18.0
    90853 Group Psychotherapy 0 0 0.0 0.0
    90875 Biofeedback Training 0 0 0.0 0.0
    90882 Environmental Intervention 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 0 0 0.0 0.0
    90899 Unlisted Psychiatric Service 1 1 1.0 1.0
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 0 0 0.0 0.0
    97151 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 0 0 0.0 0.0
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 0 0 0.0 0.0
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 0 0 0.0 0.0
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 0 0 0.0 0.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 0 0 0.0 0.0
    97157 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 0 0 0.0 0.0
    99366 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 14 35 35.0 2.5
    H0032 Individual Treatment Plan Development and Monitoring 0 0 0.0 0.0
    H2012 Behavioral Health Day Treatment (General Day Treatment) 5 478 1,363.0 272.6
    H2014 Skills Training 3 68 453.0 151.0
    H2015 Crisis Assistance 0 0 0.0 0.0
    H2019 Mental Health Behavioral Aide 1 182 1,904.0 0.0
    T1013 Sign Language or Oral Interpreter Services 8 38 287.0 35.9
    T1018 School-based IEP Services, Bundled 0 0 0.0 0.0
    T1024 EIDBI Coordinated Care Conference 0 0 0.0 0.0
    T1027 Family/Caregiver Training and Counseling 0 0 0.0 0.0


    Table 6b. Hennepin Health: Types of treatment provided to children with ASD by category of service (n=27)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 1 38 43.0 0.0
    053 Speech Therapy 16 333 333.0 20.8
    054 Occupational Therapy 14 332 901.0 64.4


    Table 7a. Itasca Medical Care: Types of treatment provided to children with ASD by procedure code (n=16)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    0359T Comprehensive Multi-Disciplinary Evaluation (CMDE) 0 0 0.0 0.0
    0362T EIDBI Intervention Observation and Direction, first 30 minutes 0 0 0.0 0.0
    0363T EIDBI Intervention Observation and Direction, additional 30 minutes 0 0 0.0 0.0
    0364T EIDBI Intervention - Individual, first 30 minutes 0 0 0.0 0.0
    0365T EIDBI Intervention - Individual, additional 30 minutes 0 0 0.0 0.0
    0366T EIDBI Intervention - Group, first 30 minutes 0 0 0.0 0.0
    0367T EIDBI Intervention - Group, additional 30 minutes 0 0 0.0 0.0
    0368T EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes 0 0 0.0 0.0
    0369T EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes 0 0 0.0 0.0
    90832 Psychotherapy, 30 min 2 2 2.0 1.0
    90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
    90834 Psychotherapy, 45 min 3 11 11.0 3.7
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 5 21 21.0 4.2
    90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 0 0 0.0 0.0
    90840 Psychotherapy for Crisis, additional 30 minutes 0 0 0.0 0.0
    90846 Family Psychotherapy - Without Patient Present 4 4 4.0 1.0
    90847 Family Psychotherapy - With Patient Present 5 16 16.0 3.2
    90849 Multiple Family Group Psychotherapy 0 0 0.0 0.0
    90853 Group Psychotherapy 1 4 4.0 4.0
    90875 Biofeedback Training 0 0 0.0 0.0
    90882 Environmental Intervention 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 0 0 0.0 0.0
    90899 Unlisted Psychiatric Service 1 3 3.0 3.0
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 0 0 0.0 0.0
    97151 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 0 0 0.0 0.0
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 0 0 0.0 0.0
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 0 0 0.0 0.0
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 0 0 0.0 0.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 0 0 0.0 0.0
    97157 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 0 0 0.0 0.0
    99366 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 4 8 8.0 2.0
    H0032 Individual Treatment Plan Development and Monitoring 3 7 7.0 2.3
    H2012 Behavioral Health Day Treatment (General Day Treatment) 0 0 0.0 0.0
    H2014 Skills Training 6 161 1,065.0 177.5
    H2015 Crisis Assistance 2 2 8.0 4.0
    H2019 Mental Health Behavioral Aide 0 0 0.0 0.0
    T1013 Sign Language or Oral Interpreter Services 0 0 0.0 0.0
    T1018 School-based IEP Services, Bundled 0 0 0.0 0.0
    T1024 EIDBI Coordinated Care Conference 0 0 0.0 0.0
    T1027 Family/Caregiver Training and Counseling 0 0 0.0 0.0


    Table 7b. Itasca Medical Care: Types of treatment provided to children with ASD by category of service (n=16)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 2 67 79.0 39.5
    053 Speech Therapy 9 152 152.0 16.9
    054 Occupational Therapy 10 164 303.0 30.3


    Table 8a. Medica: Types of treatment provided to children with ASD by procedure code (n=0)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    0359T Comprehensive Multi-Disciplinary Evaluation (CMDE) 0 0 0 0.0
    0362T EIDBI Intervention Observation and Direction, first 30 minutes 0 0 0 0.0
    0363T EIDBI Intervention Observation and Direction, additional 30 minutes 0 0 0 0.0
    0364T EIDBI Intervention - Individual, first 30 minutes 0 0 0 0.0
    0365T EIDBI Intervention - Individual, additional 30 minutes 0 0 0 0.0
    0366T EIDBI Intervention - Group, first 30 minutes 0 0 0 0.0
    0367T EIDBI Intervention - Group, additional 30 minutes 0 0 0 0.0
    0368T EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes 0 0 0 0.0
    0369T EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes 0 0 0 0.0
    90832 Psychotherapy, 30 min 0 0 0 0.0
    90833 Psychotherapy with E&M, 30 minutes 0 0 0 0.0
    90834 Psychotherapy, 45 min 0 0 0 0.0
    90836 Psychotherapy with E&M, 45 min 0 0 0 0.0
    90837 Psychotherapy, 60 min 0 0 0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 0 0 0 0.0
    90840 Psychotherapy for Crisis, additional 30 minutes 0 0 0 0.0
    90846 Family Psychotherapy - Without Patient Present 0 0 0 0.0
    90847 Family Psychotherapy - With Patient Present 0 0 0 0.0
    90849 Multiple Family Group Psychotherapy 0 0 0 0.0
    90853 Group Psychotherapy 0 0 0 0.0
    90875 Biofeedback Training 0 0 0 0.0
    90882 Environmental Intervention 0 0 0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 0 0 0 0.0
    90899 Unlisted Psychiatric Service 0 0 0 0.0
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 0 0 0 0.0
    H0031 Administering and Reporting Standardized Measures 0 0 0 0.0
    H0032 Individual Treatment Plan Development and Monitoring 0 0 0 0.0
    H2012 Behavioral Health Day Treatment (General Day Treatment) 0 0 0 0.0
    H2014 Skills Training 0 0 0 0.0
    H2015 Crisis Assistance 0 0 0 0.0
    H2019 Mental Health Behavioral Aide 0 0 0 0.0
    T1013 Sign Language or Oral Interpreter Services 0 0 0 0.0
    T1018 School-based IEP Services, Bundled 0 0 0 0.0
    T1024 EIDBI Coordinated Care Conference 0 0 0 0.0
    T1027 Family/Caregiver Training and Counseling 0 0 0 0.0


    Table 8b. Medica: Types of treatment provided to children with ASD by category of service (n=0)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 0 0 0 0.0
    053 Speech Therapy 0 0 0 0.0
    054 Occupational Therapy 0 0 0 0.0


    Table 9a. PrimeWest: Types of treatment provided to children with ASD by procedure code (n=122)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    0359T Comprehensive Multi-Disciplinary Evaluation (CMDE) 0 0 0.0 0.0
    0362T EIDBI Intervention Observation and Direction, first 30 minutes 0 0 0.0 0.0
    0363T EIDBI Intervention Observation and Direction, additional 30 minutes 0 0 0.0 0.0
    0364T EIDBI Intervention - Individual, first 30 minutes 0 0 0.0 0.0
    0365T EIDBI Intervention - Individual, additional 30 minutes 0 0 0.0 0.0
    0366T EIDBI Intervention - Group, first 30 minutes 0 0 0.0 0.0
    0367T EIDBI Intervention - Group, additional 30 minutes 0 0 0.0 0.0
    0368T EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes 0 0 0.0 0.0
    0369T EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes 0 0 0.0 0.0
    90832 Psychotherapy, 30 min 9 22 22.0 2.4
    90833 Psychotherapy with E&M, 30 minutes 1 1 1.0 0.0
    90834 Psychotherapy, 45 min 18 74 74.0 4.1
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 29 183 183.0 6.3
    90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 0 0 0.0 0.0
    90840 Psychotherapy for Crisis, additional 30 minutes 0 0 0.0 0.0
    90846 Family Psychotherapy - Without Patient Present 24 61 61.0 2.5
    90847 Family Psychotherapy - With Patient Present 25 90 90.0 3.6
    90849 Multiple Family Group Psychotherapy 0 0 0.0 0.0
    90853 Group Psychotherapy 1 3 3.0 3.0
    90875 Biofeedback Training 0 0 0.0 0.0
    90882 Environmental Intervention 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 2 2 2.0 1.0
    90899 Unlisted Psychiatric Service 6 7 7.0 1.2
    97151 Psychiatric Consultation (Unlisted Evaluation and Management) 4 11 111.0 27.8
    97153 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 5 2,262 15,999.0 3,199.8
    97154 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 3 52 214.0 71.3
    97155 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 5 167 812.0 162.4
    97156 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 5 175 1,404.0 280.8
    97157 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 2 21 156.0 78.0
    99366 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 0 0 0.0 0.0
    99499 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 20 34 34.0 1.7
    H0032 Individual Treatment Plan Development and Monitoring 13 197 197.0 15.2
    H2012 Behavioral Health Day Treatment (General Day Treatment) 1 21 63.0 63.0
    H2014 Skills Training 10 207 1,205.0 120.5
    H2015 Crisis Assistance 0 0 0.0 0.0
    H2019 Mental Health Behavioral Aide 0 0 0.0 0.0
    T1013 Sign Language or Oral Interpreter Services 0 0 0.0 0.0
    T1018 School-based IEP Services, Bundled 0 0 0.0 0.0
    T1024 EIDBI Coordinated Care Conference 0 0 0.0 0.0
    T1027 Family/Caregiver Training and Counseling 0 0 0.0 0.0


    Table 9b. PrimeWest: Types of treatment provided to children with ASD by category of service (n=122)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 10 284 636 63.6
    053 Speech Therapy 55 1,250 1,250 22.7
    054 Occupational Therapy 65 2,211 4,325 66.5


    Table 10a. South Country Health Alliance: Types of treatment provided to children with ASD by procedure code (n=92)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    0359T Comprehensive Multi-Disciplinary Evaluation (CMDE) 0 0 0.0 0.0
    0362T EIDBI Intervention Observation and Direction, first 30 minutes 0 0 0.0 0.0
    0363T EIDBI Intervention Observation and Direction, additional 30 minutes 0 0 0.0 0.0
    0364T EIDBI Intervention - Individual, first 30 minutes 0 0 0.0 0.0
    0365T EIDBI Intervention - Individual, additional 30 minutes 0 0 0.0 0.0
    0366T EIDBI Intervention - Group, first 30 minutes 0 0 0.0 0.0
    0367T EIDBI Intervention - Group, additional 30 minutes 0 0 0.0 0.0
    0368T EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes 0 0 0.0 0.0
    0369T EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes 0 0 0.0 0.0
    90832 Psychotherapy, 30 min 6 15 15.0 2.5
    90833 Psychotherapy with E&M, 30 minutes 1 1 1.0 1.0
    90834 Psychotherapy, 45 min 14 59 59.0 4.2
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 22 157 157.0 7.1
    90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 0 0 0.0 0.0
    90840 Psychotherapy for Crisis, additional 30 minutes 0 0 0.0 0.0
    90846 Family Psychotherapy - Without Patient Present 14 21 21.0 1.5
    90847 Family Psychotherapy - With Patient Present 28 286 286.0 10.2
    90849 Multiple Family Group Psychotherapy 0 0 0.0 0.0
    90853 Group Psychotherapy 1 2 2.0 2.0
    90875 Biofeedback Training 0 0 0.0 0.0
    90882 Environmental Intervention 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 4 4 4.0 1.0
    90899 Unlisted Psychiatric Service 7 13 13.0 1.9
    97151 Psychiatric Consultation (Unlisted Evaluation and Management) 3 3 28.0 9.3
    97153 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 1 4 118.0 118.0
    97154 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 0 0 0.0 0.0
    97155 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 0 0 0.0 0.0
    97156 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 0 0 0.0 0.0
    97157 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 0 0 0.0 0.0
    99366 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 0 0 0.0 0.0
    99499 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 22 39 39.0 1.8
    H0032 Individual Treatment Plan Development and Monitoring 28 78 78.0 2.8
    H2012 Behavioral Health Day Treatment (General Day Treatment) 15 597 1,791.0 119.4
    H2014 Skills Training 28 1,126 8,190.0 292.5
    H2015 Crisis Assistance 0 0 0.0 0.0
    H2019 Mental Health Behavioral Aide 2 87 502.0 251.0
    T1013 Sign Language or Oral Interpreter Services 0 0 0.0 0.0
    T1018 School-based IEP Services, Bundled 0 0 0.0 0.0
    T1024 EIDBI Coordinated Care Conference 0 0 0.0 0.0
    T1027 Family/Caregiver Training and Counseling 0 0 0.0 0.0


    Table 10b. South Country Health Alliance: Types of treatment provided to children with ASD by category of service (n=92)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 5 120 171 34.2
    053 Speech Therapy 36 687 687 19.1
    054 Occupational Therapy 33 786 1,407 42.6


    Table 11a. UCare: Types of treatments provided to children with ASD by procedure code (n=849)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    0359T Comprehensive Multi-Disciplinary Evaluation (CMDE) 0 0 0.0 0.0
    0362T EIDBI Intervention Observation and Direction, first 30 minutes 0 0 0.0 0.0
    0363T EIDBI Intervention Observation and Direction, additional 30 minutes 0 0 0.0 0.0
    0364T EIDBI Intervention - Individual, first 30 minutes 0 0 0.0 0.0
    0365T EIDBI Intervention - Individual, additional 30 minutes 0 0 0.0 0.0
    0366T EIDBI Intervention - Group, first 30 minutes 0 0 0.0 0.0
    0367T EIDBI Intervention - Group, additional 30 minutes 0 0 0.0 0.0
    0368T EIDBI Intervention - Individual (Temp Increase Svcs), first 30 minutes 0 0 0.0 0.0
    0369T EIDBI Intervention - Individual (Temp Increase Svcs), additional 30 minutes 0 0 0.0 0.0
    90832 Psychotherapy, 30 min 26 32 32.0 1.2
    90833 Psychotherapy with E&M, 30 minutes 10 31 31.0 3.1
    90834 Psychotherapy, 45 min 86 354 354.0 4.1
    90836 Psychotherapy with E&M, 45 min 2 3 3.0 0.0
    90837 Psychotherapy, 60 min 97 663 663.0 6.8
    90838 Psychotherapy with E&M, 60 min 1 1 1.0 1.0
    90839 Psychotherapy for Crisis, first 60 minutes 0 0 0.0 0.0
    90840 Psychotherapy for Crisis, additional 30 minutes 0 0 0.0 0.0
    90846 Family Psychotherapy - Without Patient Present 230 1,196 1,196.0 5.2
    90847 Family Psychotherapy - With Patient Present 216 1,177 1,177.0 5.4
    90849 Multiple Family Group Psychotherapy 9 27 27.0 3.0
    90853 Group Psychotherapy 15 0 0.0 0.0
    90875 Biofeedback Training 0 0 0.0 0.0
    90882 Environmental Intervention 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 7 8 8.0 1.1
    90899 Unlisted Psychiatric Service 29 82 83.0 2.9
    97151 Psychiatric Consultation (Unlisted Evaluation and Management) 23 89 1,060.0 46.1
    97153 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 15 666 11,772.0 784.8
    97154 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 3 69 251.0 83.7
    97155 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 8 129 1,058.0 132.3
    97156 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 6 23 76.0 12.7
    97157 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 0 0 0.0 0.0
    99366 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 1 1 1.0 1.0
    99499 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 299 808 808.0 2.7
    H0032 Individual Treatment Plan Development and Monitoring 92 753 806.0 8.8
    H2012 Behavioral Health Day Treatment (General Day Treatment) 143 15,871 47,163.0 329.8
    H2014 Skills Training 123 7,137 76,873.0 625.0
    H2015 Crisis Assistance 0 0 0.0 0.0
    H2019 Mental Health Behavioral Aide 19 1,534 19,959.0 1,050.5
    T1013 Sign Language or Oral Interpreter Services 219 4,306 17,409.0 79.5
    T1018 School-based IEP Services, Bundled 0 0 0.0 0.0
    T1024 EIDBI Coordinated Care Conference 0 0 0.0 0.0
    T1027 Family/Caregiver Training and Counseling 0 0 0.0 0.0


    Table 11b. UCare: Types of treatments provided to children with ASD by category of service (n=849)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 64 1,080 1,961 30.6
    053 Speech Therapy 468 10,678 10,680 22.8
    054 Occupational Therapy 431 9,868 26,972 62.6


    Notes

    • Data are limited to final version Minnesota Health Care Programs (MHCP) paid claims with service dates between Jan. 1, 2019, through Dec. 31, 2019, inclusive.
    • Analysis was limited to children enrolled in a managed care organization (MCO). MCO assignment was selected based on the MCO in which the recipient had the most months of enrollment during the year. If a recipient was enrolled in fee-for-service (FFS) for the most months during the year, then they were excluded from this analysis.
    • Only managed care claims were included in analysis.
    • Age was calculated as of Dec. 31, 2019.
    • Analysis was limited to children aged 1 through 6.
    • Diagnostic assessments were identified using procedure codes 90791, 90792, 90785, 96101, 96102, 96103, 96116, 96118, 96119 and 90887.
    • Children with a diagnosis of autism spectrum disorder (ASD) were identified with claims having an ICD10CM diagnosis code of F84.0, F84.2, F84.3, F84.5, F84.8 or F84.9.
    • Treatments for children with a diagnosis of ASD were identified with claims having a procedure code beginning with 908 or equal to H0031, H2012, H2014, H2015, H2019, 99499 (CTSS and other mental health services); having a procedure code of T1013 or T1018 (IEP services); having a procedure code of 0359T, 0362T-0369T, T1024, T1027, H0032 , 97151, 99366, 97153, 97154, 97155, 97156, 97157 (EIDBI services); or having category of service of 051 (physical therapy), 053 (speech therapy), or 054 (occupational therapy). The service count is the sum of all the unique services for all the children in each respective MCO. These counts were deduplicated using standard DHS procedures.
    • All treatment claims were deduplicated using standard operating procedures.
    • Analysis was designed in adherence to Minn. Stat. 256B.69, subd. 32a. (see below).

    Minn. Stat. 256B.69, subd. 32a

    Initiatives to improve early screening, diagnosis, and treatment of children with autism spectrum disorder and other developmental conditions.

    (a) The commissioner shall require managed care plans and county-based purchasing plans, as a condition of contract, to implement strategies that facilitate access for young children between the ages of one and three years to periodic developmental and social-emotional screenings, as recommended by the Minnesota Interagency Developmental Screening Task Force, and that those children who do not meet milestones are provided access to appropriate evaluation and assessment, including treatment recommendations, expected to improve the child's functioning, with the goal of meeting milestones by age five.

    (b) The following information from encounter data provided to the commissioner shall be reported on the department's public Web site for each managed care plan and county-based purchasing plan annually by July 31 of each year beginning in 2014:

    (1) the number of children who received a diagnostic assessment;

    (2) the total number of children ages one to six with a diagnosis of autism spectrum disorder who received treatments;

    (3) the number of children identified under clause (2) reported by each 12-month age group beginning with age one and ending with age six; and

    (4) the types of treatments provided to children identified under clause (2) listed by billing code, including the number of units billed for each child.

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