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    Data from 2013 calendar year

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

    MCO Number of children (Age 1 - 3) Number of children (Age 4 - 6)
    Blue Plus 148 875
    HealthPartners 91 476
    Itasca Medical Care 15 76
    Medica 176 775
    PrimeWest 51 202
    South Country Health Alliance 25 191
    UCare 282 1,177
    MCOs overall 788 3,772


    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 treatments
    Blue Plus 170 126
    HealthPartners 106 72
    Itasca Medical Care 11 9
    Medica 140 101
    PrimeWest 35 31
    South Country Health Alliance 33 25
    UCare 256 170
    MCOs overall 751 534


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

    MCO 1-year-olds with ASD 1-year-olds receiving treatment 2-year-olds with ASD 2-year-olds receiving treatment 3-year-olds with ASD 3-year-olds receiving treatment
    Blue Plus 0 0 12 12 29 23
    HealthPartners 2 0 9 6 20 19
    Itasca Medical Care 0 0 1 0 3 3
    Medica 0 0 10 7 30 25
    PrimeWest 0 0 6 6 10 7
    South Country Health Alliance 1 0 1 1 5 4
    UCare 3 3 26 18 42 29
    MHCP overall 6 3 65 50 139 110


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

    MCO 4-year-olds with ASD 4-year-olds receiving treatment 5-year-olds with ASD 5-year-olds receiving treatment 6-year-olds with ASD 6-year-olds receiving treatment
    Blue Plus 30 20 49 35 50 36
    HealthPartners 26 18 24 16 25 13
    Itasca Medical Care 2 2 3 2 2 2
    Medica 31 24 34 23 35 22
    PrimeWest 7 6 5 5 7 7
    South Country Health Alliance 7 5 10 7 9 8
    UCare 57 38 64 43 64 39
    MHCP overall 160 113 189 131 192 127


    Table 4a. Blue Plus: Types of treatments provided to children with ASD by procedure code (n=170)

    Procedure code Description Unique number of children receiving service Count of services Total units paid Average units
    90832 Psychotherapy, 30 minutes 10 25 25.0 2.5
    90833 Psychotherapy with evaluation & management, 30 minutes 3 6 6.0 2.0
    90834 Psychotherapy, 45 minutes 23 99 99.0 4.3
    90836 Psychotherapy with evaluation & management, 45 minutes 1 1 1.0 1.0
    90837 Psychotherapy, 60 minutes 32 188 188.0 5.9
    90838 Psychotherapy with evaluation & management, 60 minutes 1 1 1.0 1.0
    90846 Family Psychotherapy - without patient present 23 56 56.0 2.4
    90847 Family Psychotherapy - with patient present 41 210 210.0 5.1
    90849 Multiple Family Group Psychotherapy 1 4 4.0 4.0
    90853 Group Psychotherapy (Other than multiple-family group) 0 0 0.0 N/A
    90887 Interpretation of psychiatric and other medical examination 1 1 1.0 1.0
    90899 Preparation of report of patient's status, hx, treatment, or progress 6 100 493.0 82.2
    99499 Psychiatric Consultation (Unlisted evaluation and management) 0 0 0.0 N/A
    H2012 Behavioral Health Day Treatment (General Day Treatment), 60 minutes 4 385 1,148.0 287.0
    H2014 Skills Training and Development, 15 minutes 32 947 8,148.0 254.6
    H2015 Crisis Assistance (Comprehensive community support services), 15 minutes 0 0 0.0 N/A
    H2019 Mental Health Behavioral Aide, 15 minutes 2 39 306.0 153.0


    Table 4b. Blue Plus: Types of treatments provided to children with ASD by category of service (n=170)

    Category of service Description Unique number of children receiving service Count of services Total units paid Average units
    051 Physical Therapy 16 277 650.0 40.6
    053 Speech Therapy 50 1,088 1,089.0 21.8
    054 Occupational Therapy 53 993 2,403.0 45.3


    Table 5a. HealthPartners: Types of treatment provided to children with ASD by procedure code (n=106)

    Procedure code Description Unique number of children receiving service Count of services Total units paid Average units
    90832 Psychotherapy, 30 minutes 3 4 4.0 1.3
    90833 Psychotherapy with evaluation & management, 30 minutes 0 0 0.0 N/A
    90834 Psychotherapy, 45 minutes 8 46 46.0 5.8
    90836 Psychotherapy with evaluation & management, 45 minutes 0 0 0.0 N/A
    90837 Psychotherapy, 60 minutes 8 18 18.0 2.3
    90838 Psychotherapy with evaluation & management, 60 minutes 0 0 0.0 N/A
    90846 Family Psychotherapy - without patient present 25 96 96.0 3.8
    90847 Family Psychotherapy - with patient present 18 79 79.0 4.4
    90849 Multiple Family Group Psychotherapy 0 0 0.0 N/A
    90853 Group Psychotherapy (Other than multiple-family group) 0 0 0.0 N/A
    90887 Interpretation of psychiatric and other medical examination 2 2 2.0 1.0
    90899 Preparation of report of patient's status, hx, treatment, or progress 0 0 0.0 N/A
    99499 Psychiatric Consultation (Unlisted evaluation and management) 0 0 0.0 N/A
    H2012 Behavioral Health Day Treatment (General Day Treatment), 60 minutes 17 1,090 3,333.9 196.1
    H2014 Skills Training and Development, 15 minutes 12 252 1,773.0 147.8
    H2015 Crisis Assistance (Comprehensive community support services), 15 minutes 0 0 0.0 N/A
    H2019 Mental Health Behavioral Aide, 15 minutes 0 0 0.0 N/A


    Table 5b. HealthPartners: Types of treatment provided to children with ASD by category of service (n=106)

    Category of service Description Unique number of children receiving service Count of services Total units paid Average units
    051 Physical Therapy 11 353 964.0 87.6
    053 Speech Therapy 44 1,223 1,223.0 27.8
    054 Occupational Therapy 39 1,363 3,144.0 80.6


    Table 6a. Itasca Medical Care: Types of treatment provided to children with ASD by procedure code (n=11)

    Procedure code Description Unique number of children receiving service Count of services Total units paid Average units
    90832 Psychotherapy, 30 minutes 3 4 4.0 1.3
    90833 Psychotherapy with evaluation & management, 30 minutes 0 0 0.0 N/A
    90834 Psychotherapy, 45 minutes 2 26 26.0 13.0
    90836 Psychotherapy with evaluation & management, 45 minutes 0 0 0.0 N/A
    90837 Psychotherapy, 60 minutes 3 31 31.0 10.3
    90838 Psychotherapy with evaluation & management, 60 minutes 0 0 0.0 N/A
    90846 Family Psychotherapy - without patient present 3 8 8.0 2.7
    90847 Family Psychotherapy - with patient present 1 11 11.0 11.0
    90849 Multiple Family Group Psychotherapy 0 0 0.0 N/A
    90853 Group Psychotherapy (Other than multiple-family group) 0 0 0.0 N/A
    90887 Interpretation of psychiatric and other medical examination 2 2 2.0 1.0
    90899 Preparation of report of patient's status, hx, treatment, or progress 0 0 0.0 N/A
    99499 Psychiatric Consultation (Unlisted evaluation and management) 0 0 0.0 N/A
    H2012 Behavioral Health Day Treatment (General Day Treatment), 60 minutes 0 0 0.0 N/A
    H2014 Skills Training and Development, 15 minutes 7 195 1,257.0 179.6
    H2015 Crisis Assistance (Comprehensive community support services), 15 minutes 0 0 0.0 N/A
    H2019 Mental Health Behavioral Aide, 15 minutes 1 94 626.0 626.0


    Table 6b. Itasca Medical Care: Types of treatment provided to children with ASD by category of service (n=11)

    Category of service Description Unique number of children receiving service Count of services Total units paid Average units
    051 Physical Therapy 0 0 0.0 N/A
    053 Speech Therapy 4 44 44.0 11.0
    054 Occupational Therapy 1 21 60.0 60.0


    Table 7a. Medica: Types of treatment provided to children with ASD by procedure code (n=140)

    Procedure code Description Unique number of children receiving service Count of services Total units paid Average units
    90832 Psychotherapy, 30 minutes 2 4 4.0 2.0
    90833 Psychotherapy with evaluation & management, 30 minutes 1 1 1.0 1.0
    90834 Psychotherapy, 45 minutes 15 45 45.0 3.0
    90836 Psychotherapy with evaluation & management, 45 minutes 0 0 0.0 N/A
    90837 Psychotherapy, 60 minutes 12 47 47.0 3.9
    90838 Psychotherapy with evaluation & management, 60 minutes 0 0 0.0 N/A
    90846 Family Psychotherapy - without patient present 30 58 58.0 1.9
    90847 Family Psychotherapy - with patient present 28 80 80.0 2.9
    90849 Multiple Family Group Psychotherapy 0 0 0.0 N/A
    90853 Group Psychotherapy (Other than multiple-family group) 1 1 1.0 1.0
    90887 Interpretation of psychiatric and other medical examination 8 9 9.0 1.1
    90899 Preparation of report of patient's status, hx, treatment, or progress 8 70 70.0 8.8
    99499 Psychiatric Consultation (Unlisted evaluation and management) 0 0 0.0 N/A
    H2012 Behavioral Health Day Treatment (General Day Treatment), 60 minutes 24 2,036 3,951.0 164.6
    H2014 Skills Training and Development, 15 minutes 25 425 2,783.0 111.3
    H2015 Crisis Assistance (Comprehensive community support services), 15 minutes 1 1 3.0 3.0
    H2019 Mental Health Behavioral Aide, 15 minutes 4 109 1,221.0 305.3


    Table 7b. Medica: Types of treatment provided to children with ASD by category of service (n=140)

    Category of service Description Unique number of children receiving service Count of services Total units paid Average units
    051 Physical Therapy 15 422 943.0 62.9
    053 Speech Therapy 66 1,774 1,774.0 26.9
    054 Occupational Therapy 66 1,731 4,506.0 68.3


    Table 8a. PrimeWest: Types of treatment provided to children with ASD by procedure code (n=35)

    Procedure code Description Unique number of children receiving service Count of services Total units paid Average units
    90832 Psychotherapy, 30 minutes 3 3 3.0 1.0
    90833 Psychotherapy with evaluation & management, 30 minutes 0 0 0.0 N/A
    90834 Psychotherapy, 45 minutes 7 35 35.0 5.0
    90836 Psychotherapy with evaluation & management, 45 minutes 0 0 0.0 N/A
    90837 Psychotherapy, 60 minutes 4 28 28.0 7.0
    90838 Psychotherapy with evaluation & management, 60 minutes 0 0 0.0 N/A
    90846 Family Psychotherapy - without patient present 6 14 14.0 2.3
    90847 Family Psychotherapy - with patient present 4 69 69.0 17.3
    90849 Multiple Family Group Psychotherapy 0 0 0.0 N/A
    90853 Group Psychotherapy (Other than multiple-family group) 0 0 0.0 N/A
    90887 Interpretation of psychiatric and other medical examination 6 6 6.0 1.0
    90899 Preparation of report of patient's status, hx, treatment, or progress 0 0 0.0 N/A
    99499 Psychiatric Consultation (Unlisted evaluation and management) 0 0 0.0 N/A
    H2012 Behavioral Health Day Treatment (General Day Treatment), 60 minutes 0 0 0.0 N/A
    H2014 Skills Training and Development, 15 minutes 10 169 1,140.0 114.0
    H2015 Crisis Assistance (Comprehensive community support services), 15 minutes 0 0 0.0 N/A
    H2019 Mental Health Behavioral Aide, 15 minutes 0 0 0.0 N/A


    Table 8b. PrimeWest: Types of treatment provided to children with ASD by category of service (n=35)

    Category of service Description Unique number of children receiving service Count of services Total units paid Average units
    051 Physical Therapy 8 136 2,087.0 260.9
    053 Speech Therapy 15 197 197.0 13.1
    054 Occupational Therapy 23 416 769.0 33.4


    Table 9a. South Country Health Alliance: Types of treatment provided to children with ASD by procedure code (n=33)

    Procedure code Description Unique number of children receiving service Count of services Total units paid Average units
    90832 Psychotherapy, 30 minutes 0 0 0.0 N/A
    90833 Psychotherapy with evaluation & management, 30 minutes 0 0 0.0 N/A
    90834 Psychotherapy, 45 minutes 6 28 28.0 4.7
    90836 Psychotherapy with evaluation & management, 45 minutes 0 0 0.0 N/A
    90837 Psychotherapy, 60 minutes 6 36 36.0 6.0
    90838 Psychotherapy with evaluation & management, 60 minutes 0 0 0.0 N/A
    90846 Family Psychotherapy - without patient present 7 13 13.0 1.9
    90847 Family Psychotherapy - with patient present 8 42 42.0 5.3
    90849 Multiple Family Group Psychotherapy 0 0 0.0 N/A
    90853 Group Psychotherapy (Other than multiple-family group) 0 0 0.0 N/A
    90887 Interpretation of psychiatric and other medical examination 1 1 1.0 1.0
    90899 Preparation of report of patient's status, hx, treatment, or progress 0 0 0.0 N/A
    99499 Psychiatric Consultation (Unlisted evaluation and management) 0 0 0.0 N/A
    H2012 Behavioral Health Day Treatment (General Day Treatment), 60 minutes 0 0 0.0 N/A
    H2014 Skills Training and Development, 15 minutes 13 524 4,999.0 384.5
    H2015 Crisis Assistance (Comprehensive community support services), 15 minutes 0 0 0.0 N/A
    H2019 Mental Health Behavioral Aide, 15 minutes 2 43 338.0 169.0


    Table 9b. South Country Health Alliance: Types of treatment provided to children with ASD by category of service (n=33)

    Category of service Description Unique number of children receiving service Count of services Total units paid Average units
    051 Physical Therapy 4 61 92.0 23.0
    053 Speech Therapy 9 244 244.0 27.1
    054 Occupational Therapy 11 274 369.0 33.5


    Table 10a. UCare: Types of treatments provided to children with ASD by procedure code (n=256)

    Procedure code Description Unique number of children receiving service Count of services Total units paid Average units
    90832 Psychotherapy, 30 minutes 8 22 22.0 2.8
    90833 Psychotherapy with evaluation & management, 30 minutes 1 2 2.0 2.0
    90834 Psychotherapy, 45 minutes 16 84 84.0 5.3
    90836 Psychotherapy with evaluation & management, 45 minutes 0 0 0.0 N/A
    90837 Psychotherapy, 60 minutes 25 100 100.0 4.0
    90838 Psychotherapy with evaluation & management, 60 minutes 0 0 0.0 N/A
    90846 Family Psychotherapy - without patient present 46 138 138.0 3.0
    90847 Family Psychotherapy - with patient present 60 250 250.0 4.2
    90849 Multiple Family Group Psychotherapy 0 0 0.0 N/A
    90853 Group Psychotherapy (Other than multiple-family group) 4 26 26.0 6.5
    90887 Interpretation of psychiatric and other medical examination 17 19 19.0 1.1
    90899 Preparation of report of patient's status, hx, treatment, or progress 0 0 0.0 N/A
    99499 Psychiatric Consultation (Unlisted evaluation and management) 0 0 0.0 N/A
    H2012 Behavioral Health Day Treatment (General Day Treatment), 60 minutes 19 1,461 4,330.0 227.9
    H2014 Skills Training and Development, 15 minutes 43 1,323 8,282.0 192.6
    H2015 Crisis Assistance (Comprehensive community support services), 15 minutes 3 3 16.0 5.3
    H2019 Mental Health Behavioral Aide, 15 minutes 5 230 1,711.0 342.2


    Table 10b. UCare: Types of treatments provided to children with ASD by category of service (n=256)

    Category of service Description Unique number of children receiving service Count of services Total units paid Average units
    051 Physical Therapy 17 175 274.0 16.1
    053 Speech Therapy 104 2,213 2,213.0 21.3
    054 Occupational Therapy 97 2,829 6,478.0 66.8


    Notes

    1) Data are limited to final version of Minnesota Health Care Programs-paid claims with service dates between Jan. 1, 2013, through Dec. 31, 2013, inclusive.

    2) Analysis was limited to children enrolled in a managed-care organization. MCO assignment was selected based on the MCO in which the recipient had the most months of enrollment during the year. If a person was enrolled in fee-for-service for more months than he or she was enrolled in an MCO during the year, then he or she was excluded from this analysis.

    3) Only Managed care claims were included in analysis.

    4) Age was calculated as of Dec. 31, 2013.

    5) Analysis was limited to children aged 1 through 6.

    6) Diagnostic assessments were identified using procedure codes 90791, 90702 and 90785.

    7) Children with a diagnosis of autism spectrum disorder (ASD) were identified with claims having a diagnosis code of 299.0 (Autistic disorder) and 299.8 (Other specified pervasive developmental disorders).

    8) Treatments for children with a diagnosis of ASD were identified with claims having a procedure code beginning with 908; having a procedure code of H2014, T1018, H2015, H2019, H2012, 99499; or claims with category of service of 051 (Physical Therapy), 053 (Speech Therapy), and 054 (Occupational Therapy). The service count is sum of all the unique services for all the children in each respective MCO. These counts were deduplicated using standard DHS procedures.

    9) All treatment claims were de-duplicated using standard operating procedures.

    10) Analysis was designed in adherence to Minn. Stat. 256B.69, Subd. 32a. (see below).

    Minnesota Statutes 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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