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    Data from 2020 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 510 2,179
    HealthPartners 202 767
    Hennepin Health 13 42
    Itasca Medical Care 12 49
    Medica 0 0
    PrimeWest 66 292
    South Country Health Alliance 37 154
    UCare 347 1,365
    MCOs Overall 1,187 4,848


    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 1,013 805
    HealthPartners 416 324
    Hennepin Health 27 25
    Itasca Medical Care 13 10
    Medica 0 0
    PrimeWest 113 93
    South Country Health Alliance 55 36
    UCare 923 725
    MCOs Overall 2,560 2,018


    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 who received treatments # 2-year-olds with ASD # 2-year-olds who received treatments # 3-year-olds with ASD # 3-year-olds who received treatments
    Blue Plus 9 9 88 71 189 160
    HealthPartners 4 3 28 25 81 67
    Hennepin Health 1 1 1 1 3 2
    Itasca Medical Care 1 1 2 2 3 3
    Medica 0 0 0 0 0 0
    PrimeWest 0 0 6 6 18 14
    South Country Health Alliance 1 0 5 5 4 4
    UCare 6 5 71 54 184 158
    MHCP Overall 22 19 201 164 482 408


    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 who received treatments # 5-year-olds with ASD # 5-year-olds who received treatments # 6-year-olds with ASD # 6-year-olds who received treatments
    Blue Plus 244 192 257 209 226 164
    HealthPartners 102 87 96 71 105 71
    Hennepin Health 7 7 11 10 4 4
    Itasca Medical Care 0 0 4 3 3 1
    Medica 0 0 0 0 0 0
    PrimeWest 31 27 20 15 38 31
    South Country Health Alliance 11 7 16 9 18 11
    UCare 236 197 215 164 211 147
    MHCP Overall 631 517 619 481 605 429


    Table 4a. Blue Plus: Types of treatments provided to children with ASD by procedure code (n=1,013)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 70 178 178.0 2.5
    90833 Psychotherapy with E&M, 30 minutes 17 45 45.0 2.6
    90834 Psychotherapy, 45 min 126 459 459.0 3.6
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 181 1,278 1,279.0 7.1
    90838 Psychotherapy with E&M, 60 min 1 1 1.0 1.0
    90839 Psychotherapy for Crisis, first 60 minutes 2 2 2.0 1.0
    90846 Family Psychotherapy - Without Patient Present 239 1,263 1,263.0 5.3
    90847 Family Psychotherapy - With Patient Present 214 1,313 1,313.0 6.1
    90849 Multiple Family Group Psychotherapy 3 16 16.0 5.3
    90853 Group Psychotherapy 4 23 23.0 5.8
    90887 Interpretation of Psychiatric and Other MedicalExamination 18 18 18.0 1.0
    90899 Unlisted Psychiatric Service 48 119 121.0 2.5
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 71 8,196 110,177.0 1,551.8
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 23 1,111 4,769.0 207.3
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 68 2,359 15,997.0 235.3
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 53 592 2,405.0 45.4
    97157 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 4 10 50.0 12.5
    99366 Coordinated Care Conference: Medical Team Conference 10 15 15.0 1.5
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 2 2 2.0 1.0
    H0031 Administering and Reporting Standardized Measures 298 1,069 1,069.0 3.6
    H0032 Individual Treatment Plan Development and Monitoring 238 2,016 2,056.0 8.6
    H2012 Behavioral Health Day Treatment (General Day Treatment) 70 5,568 16,587.0 237.0
    H2014 Skills Training 129 4,671 67,241.0 521.2
    H2015 Crisis Assistance 3 5 9.0 3.0
    H2019 Mental Health Behavioral Aide 6 347 4,093.0 682.2
    T1013 Sign Language or Oral Interpreter Services 109 825 2,966.0 27.2
    T1027 Family/Caregiver Training and Counseling 1 1 2.0 2.0


    Table 4b. Blue Plus: Types of treatments provided to children with ASD by category of service (n=1,013)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 118 2401 4375 37.1
    053 Speech Therapy 528 12014 12015 22.8
    054 Occupational Therapy 511 11897 30779 60.2


    Table 5a. HealthPartners: Types of treatment provided to children with ASD by procedure code (n=416)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 25 59 59.0 2.4
    90833 Psychotherapy with E&M, 30 minutes 3 18 18.0 6.0
    90834 Psychotherapy, 45 min 44 163 163.0 3.7
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 55 361 361.0 6.6
    90838 Psychotherapy with E&M, 60 min 0 0 0.0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 2 3 3.0 1.5
    90846 Family Psychotherapy - Without Patient Present 133 827 827.0 6.2
    90847 Family Psychotherapy - With Patient Present 111 636 636.0 5.7
    90849 Multiple Family Group Psychotherapy 2 5 5.0 2.5
    90853 Group Psychotherapy 1 1 1.0 1.0
    90887 Interpretation of Psychiatric and Other MedicalExamination 8 8 8.0 1.0
    90899 Unlisted Psychiatric Service 21 38 38.0 1.8
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 22 2,274 40,798.0 1,854.5
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 13 613 3,351.0 257.8
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 23 888 6,285.0 273.3
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 19 224 787.0 41.4
    97157 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 1 3 22.0 22.0
    99366 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 153 598 598.0 3.9
    H0032 Individual Treatment Plan Development and Monitoring 100 768 768.0 7.7
    H2012 Behavioral Health Day Treatment (General Day Treatment) 59 4,770 14,773.0 250.4
    H2014 Skills Training 39 789 7,032.0 180.3
    H2015 Crisis Assistance 1 1 1.0 1.0
    H2019 Mental Health Behavioral Aide 4 106 1,086.0 271.5
    T1013 Sign Language or Oral Interpreter Services 32 772 3,345.0 104.5
    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=416)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 38 882 1576 41.5
    053 Speech Therapy 243 5608 5608 23.1
    054 Occupational Therapy 228 4929 14065 61.7


    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
    90832 Psychotherapy, 30 min 1 2 2.0 2.0
    90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
    90834 Psychotherapy, 45 min 1 3 3.0 2.0
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 2 10 10.0 3.0
    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
    90846 Family Psychotherapy - Without Patient Present 11 97 97.0 8.8
    90847 Family Psychotherapy - With Patient Present 8 52 52.0 6.5
    90849 Multiple Family Group Psychotherapy 1 3 3.0 8.8
    90853 Group Psychotherapy 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other MedicalExamination 0 0 0.0 0.0
    90899 Unlisted Psychiatric Service 1 2 2.0 2.0
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 1 21 242.0 242.0
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 1 16 59.0 2.0
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 1 9 29.0 242.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 1 1 8.0 59.0
    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
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 17 73 73.0 4.3
    H0032 Individual Treatment Plan Development and Monitoring 9 20 20.0 2.2
    H2012 Behavioral Health Day Treatment (General Day Treatment) 8 487 1,438.0 4.3
    H2014 Skills Training 7 41 194.0 2.2
    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 7 25 73.0 10.4
    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 1 1.0 1.0
    053 Speech Therapy 17 307 307.0 18.1
    054 Occupational Therapy 13 317 992.0 76.3


    Table 7a. Itasca Medical Care: Types of treatment provided to children with ASD by procedure code (n=13)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    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 0 0 0.0 0.0
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 1 11 11.0 11.0
    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
    90846 Family Psychotherapy - Without Patient Present 1 1 1.0 1.0
    90847 Family Psychotherapy - With Patient Present 2 3 3.0 1.5
    90849 Multiple Family Group Psychotherapy 0 0 0.0 0.0
    90853 Group Psychotherapy 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 0 0 0.0 0.0
    90899 Unlisted Psychiatric Service 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
    99499 Psychiatric Consultation (Unlisted Evaluation and Management) 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 0 0 0.0 0.0
    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 3 86 235.0 78.3
    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
    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=13)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 1 17 20.0 20.0
    053 Speech Therapy 8 143 143.0 17.9
    054 Occupational Therapy 10 125 268.0 26.8


    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=113)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 10 19 19.0 1.9
    90833 Psychotherapy with E&M, 30 minutes 1 5 5.0 5.0
    90834 Psychotherapy, 45 min 19 84 84.0 4.4
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 18 139 139.0 7.7
    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
    90846 Family Psychotherapy - Without Patient Present 21 74 74.0 3.5
    90847 Family Psychotherapy - With Patient Present 19 87 87.0 4.6
    90849 Multiple Family Group Psychotherapy 1 1 1.0 1.0
    90853 Group Psychotherapy 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 1 1 1.0 1.0
    90899 Unlisted Psychiatric Service 4 16 16.0 4.0
    97153 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 7 2,577 23,696.0 3,385.1
    97154 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 5 42 90.0 18.0
    97155 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 7 675 4,422.0 631.7
    97156 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 5 93 394.0 78.8
    97157 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 1 1 3.0 3.0
    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 21 60 60.0 2.9
    H0032 Individual Treatment Plan Development and Monitoring 21 403 403.0 19.2
    H2012 Behavioral Health Day Treatment (General Day Treatment) 1 53 158.0 158.0
    H2014 Skills Training 13 300 1,907.0 146.7
    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
    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=113)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 14 408 722 51.6
    053 Speech Therapy 53 "1,179" "1,180" 22.3
    054 Occupational Therapy 65 "1,777" "3,399" 52.3


    Table 10a. South Country Health Alliance: Types of treatment provided to children with ASD by procedure code (n=55)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 4 19 19.0 4.8
    90833 Psychotherapy with E&M, 30 minutes 1 5 5.0 5.0
    90834 Psychotherapy, 45 min 9 20 20.0 2.2
    90836 Psychotherapy with E&M, 45 min 2 6 6.0 3.0
    90837 Psychotherapy, 60 min 4 12 12.0 3.0
    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
    90846 Family Psychotherapy - Without Patient Present 7 30 30.0 4.3
    90847 Family Psychotherapy - With Patient Present 11 98 98.0 8.9
    90849 Multiple Family Group Psychotherapy 0 0 0.0 0.0
    90853 Group Psychotherapy 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 3 3 3.0 1.0
    90899 Unlisted Psychiatric Service 3 6 6.0 2.0
    97153 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 3 689 6,063.0 2,021.0
    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 3 148 675.0 225.0
    97156 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 3 28 82.0 27.3
    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 14 53 53.0 3.8
    H0032 Individual Treatment Plan Development and Monitoring 12 36 36.0 3.0
    H2012 Behavioral Health Day Treatment (General Day Treatment) 2 152 454.0 227.0
    H2014 Skills Training 9 471 2,499.0 277.7
    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
    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=55)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    51 Physical Therapy 4 65 110 27.5
    53 Speech Therapy 21 369 369 17.6
    54 Occupational Therapy 19 255 547 28.8


    Table 11a. UCare: Types of treatments provided to children with ASD by procedure code (n=923)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 47 131 131.0 2.8
    90833 Psychotherapy with E&M, 30 minutes 8 27 27.0 3.4
    90834 Psychotherapy, 45 min 81 292 292.0 3.6
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 123 757 758.0 6.2
    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
    90846 Family Psychotherapy - Without Patient Present 229 1,577 1,577.0 6.9
    90847 Family Psychotherapy - With Patient Present 210 1,058 1,058.0 5.0
    90849 Multiple Family Group Psychotherapy 3 6 6.0 2.0
    90853 Group Psychotherapy 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 12 12 12.0 1.0
    90899 Unlisted Psychiatric Service 26 49 49.0 1.9
    97153 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 69 6,031 116,603.0 1,689.9
    97154 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 29 1,667 6,641.0 229.0
    97155 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 54 2,305 13,737.0 254.4
    97156 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 48 605 2,408.0 50.2
    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 340 1,382 1,383.0 4.1
    H0032 Individual Treatment Plan Development and Monitoring 252 2,175 2,372.0 9.4
    H2012 Behavioral Health Day Treatment (General Day Treatment) 127 9,854 29,357.0 231.2
    H2014 Skills Training 152 6,130 121,423.0 798.8
    H2015 Crisis Assistance 2 2 2.0 1.0
    H2019 Mental Health Behavioral Aide 6 357 4,411.0 735.2
    T1013 Sign Language or Oral Interpreter Services 184 3,598 13,177.0 71.6
    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=923)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    51 Physical Therapy 60 1,049 1,814 30.2
    53 Speech Therapy 486 10,209 10,244 21.1
    54 Occupational Therapy 451 9,274 24,701 54.8


    Notes

    • Data are limited to final version Minnesota Health Care Programs (MHCP) paid claims with service dates between Jan. 1, 2020, and Dec. 31, 2020, 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 this analysis.
    • Age was calculated as of Dec. 31, 2020.
    • Analysis was limited to children ages 1 through 6.
    • Diagnostic assessments were identified using procedure codes 97151, 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 T1024, T1027, H0032 , 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 Minnesota Statutes 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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