Service

Procedure Code

Required Modifier

Early Intervention Screening

T1027

GT

Initial Interdisciplinary Psychosocial and Developmental Evaluation rendered by a Physical Therapist

T1024 GP UK

GT

Initial Interdisciplinary Psychosocial and Developmental Evaluation rendered by a Speech Therapist

T1024 GN UK

GT

Initial Interdisciplinary Psychosocial and Developmental Evaluation rendered by an Occupational Therapist

T1024 GO UK

GT

Initial Interdisciplinary Psychosocial and Developmental Evaluation rendered by a Licensed Early Intervention Professional

T1024 TL

GT

Initial Interdisciplinary Psychosocial and Developmental Evaluation rendered by an ITDS

T1024 HN UK

GT

Follow-up Psychosocial and Developmental Evaluation rendered by a Physical Therapist

T1024 GP TS

GT

Follow-up Psychosocial and Developmental Evaluation rendered by a Speech Therapist

T1024 GN TS

GT

Follow-up Psychosocial and Developmental Evaluation rendered by an Occupational Therapist

T1024 GO TS

GT

Follow-up Psychosocial and Developmental Evaluation rendered by a licensed Early Intervention professional

T1024 TL TS

GT

Follow-up Psychosocial and Developmental Evaluation rendered by an ITDS

T1024 TS

GT

Service

Procedure Code

Required Modifier

Limits

Early Intervention Individual Session: Family Training

T1027 SC

GT

Four 15-minute units per day

Provider Type(s): 81, 82, and 83

Update: Telemedicine Guidance for Early Intervention Services

The Agency for Health Care Administration (Agency) is committed to ensuring that Medicaid recipients continue to receive care when needed and without interruption. The purpose of this provider alert is to provide guidance to providers on how the Agency is expanding the type of Early Intervention Services (EIS) that can be delivered via telemedicine during the 2019 novel coronavirus (COVID-19) state of emergency.

This alert replaces the March 20, 2020 provider alert titled “Telemedicine Guidance for Therapy Services and Early Intervention Services” for EIS providers.

Telemedicine Definition

Telemedicine is the practice of health care delivery by a practitioner who is in a site other than the site where a recipient is located, using interactive telecommunications equipment that minimally includes real time, two-way interactive communication between a recipient and a practitioner using audio and video equipment. The Agency’s current telemedicine policy in the fee-for-service delivery system is available at: http://ahca.myflorida.com/medicaid/review/General/59G_1057_TELEMEDICINE.pdf.

Telemedicine Flexibilities During the State of Emergency

It is imperative that services continue for children in need of services. To ensure that Florida Medicaid providers can maintain continuity of care during the state of emergency, the Agency is expanding coverage of early intervention services provided through telemedicine. These flexibilities apply to services provided through both the Statewide Medicaid Managed Care program and the fee-for-service delivery system when the provider is unable to provide care physically face-to-face on that date of service (e.g. the provider is diagnosed with COVID-19, community or home-based care was not an option, etc.).

Early Intervention Screenings and Evaluations

Florida Medicaid will reimburse for the delivery of early intervention screenings and evaluations (initial and follow-up) via telemedicine when the service is delivered in accordance with federal and state law requirements (e.g., multidisciplinary team requirements can be met through live, two-way audio and video capabilities). The service must be completed in its entirety, as detailed in the EIS coverage policy and fee schedule.

Services are covered, as described below:  

Early Intervention Sessions

Florida Medicaid will reimburse for the delivery of early intervention sessions via telemedicine when performed by an eligible EIS provider (as defined in the Medicaid coverage policy) to provide family training designed to support the caregiver in the delivery of care. The provider must guide the caregiver in the implementation of certain components of the recipient’s individualized family support plan to promote carryover of treatment gains. Providers are required to ensure caregivers can perform the tasks. Services are covered, as described below:  

Provider Telemedicine Requirements

Early intervention service providers using telemedicine as a modality to deliver services must also comply with the following:

• Telemedicine services cannot be provided if another EIS provider is in the home on the same date of service.
• Ensure services are medically necessary and performed in accordance with the service specific policy and fee schedule.
• The recipient (and their legal guardian) must be present for the duration of the service provided using telemedicine.
• Telemedicine should not be used by a provider if it may result in any reduction to the quality of care or if the service delivered through this modality could adversely impact the recipient.
• Documentation regarding the use of telemedicine must be included in the progress notes for each encounter with a recipient. All other documentation requirements for the service must be met as described in the coverage policy.

• Providers must comply with the Health Insurance Portability and Accountability Act (HIPAA) when providing services; all equipment and means of communication transmission must be HIPAA compliant.
• Providers must assure that the recipient has compatible equipment and the necessary connectivity in order to send and receive uninterrupted video. Telephone (audio-only) or electronic-based contact with a Florida Medicaid recipient without a video component is not permitted.  

Reimbursement 

In the fee for service delivery system, Florida Medicaid reimburses at the same rate detailed on the respective fee schedule. Please contact the health plans directly to inquire about their reimbursement rates. 

Florida Medicaid does not reimburse for the acquisition, installation, and maintenance of telecommunication devices or systems.

Additional Information

The Agency’s COVID-19 website is available here: http://ahca.myflorida.com/covid-19_alerts.shtml. Frequently asked questions are available on this website.

QUESTIONS? [email protected]

COMPLAINTS OR ISSUES? ON LINE http://ahca.myflorida.com/Medicaid/complaints/|  CALL 1-877-254-1055

The Agency for Health Care Administration is committed to its mission of providing "Better Health Care for All Floridians." The Agency administers Florida’s Medicaid program, licenses and regulates more than 48,000 health care facilities and 47 health maintenance organizations, and publishes health care data and statistics at www.FloridaHealthFinder.gov. Additional information about Agency initiatives is available via Facebook (AHCAFlorida), Twitter (@AHCA_FL) and YouTube(/AHCAFlorida).