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    Data from 2021 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 489 2,254
    HealthPartners 246 813
    Hennepin Health 8 37
    Itasca Medical Care 8 53
    Medica 0 0
    PrimeWest 51 302
    South Country Health Alliance 23 140
    UCare 328 1,478
    MCOs Overall 1,153 5,077


    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 1,206 918
    HealthPartners 557 431
    Hennepin Health 31 22
    Itasca Medical Care 16 13
    Medica 0 0
    PrimeWest 131 102
    South Country Health Alliance 64 36
    UCare 1,113 848
    MCOs Overall 3,118 2,370


    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 12 9 112 91 192 151
    HealthPartners 8 6 54 48 105 85
    Hennepin Health 1 1 3 3 4 3
    Itasca Medical Care 0 0 4 4 2 2
    Medica 0 0 0 0 0 0
    PrimeWest 2 1 9 7 25 20
    South Country Health Alliance 1 0 4 0 15 11
    UCare 12 9 114 85 202 164
    MHCP Overall 36 26 300 238 545 436


    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 268 218 326 245 296 204
    HealthPartners 129 107 133 93 128 92
    Hennepin Health 4 3 8 6 11 6
    Itasca Medical Care 3 3 3 0 4 4
    Medica 0 0 0 0 0 0
    PrimeWest 28 22 35 29 32 23
    South Country Health Alliance 6 4 19 12 19 9
    UCare 272 220 292 219 221 151
    MHCP Overall 710 577 816 604 711 489


    Table 4a. Blue Plus: Types of treatments provided to children with ASD by procedure code (n=1,206)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 65 154 154.0 2.4
    90833 Psychotherapy with E&M, 30 minutes 8 29 29.0 3.6
    90834 Psychotherapy, 45 min 116 465 466.0 4.0
    90836 Psychotherapy with E&M, 45 min 5 8 8.0 0.0
    90837 Psychotherapy, 60 min 170 945 945.0 5.6
    90838 Psychotherapy with E&M, 60 min 1 1 1.0 1.0
    90839 Psychotherapy for Crisis, first 60 minutes 1 1 1.0 1.0
    90846 Family Psychotherapy - Without Patient Present 244 1,297 1,297.0 5.3
    90847 Family Psychotherapy - With Patient Present 207 818 818.0 4.0
    90849 Multiple Family Group Psychotherapy 5 30 30.0 6.0
    90853 Group Psychotherapy 4 37 37.0 9.3
    90887 Interpretation of Psychiatric and Other Medical Examination 12 12 12.0 1.0
    90899 Unlisted Psychiatric Service 40 92 92.0 2.3
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 125 20,891 215,352.0 1,722.8
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 51 4,680 14,135.0 277.2
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 124 6,494 46,258.0 373.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 91 967 3,696.0 40.6
    99366 Coordinated Care Conference: Medical Team Conference 8 10 10.0 1.3
    H0031 Administering and Reporting Standardized Measures 304 1,054 1,056.0 3.5
    H0032 Individual Treatment Plan Development and Monitoring 308 3,140 3,244.0 10.5
    H2012 Behavioral Health Day Treatment (General Day Treatment) 85 6,296 18,703.0 220.0
    H2014 Skills Training 111 2,994 48,657.0 438.4
    H2015 Crisis Assistance 5 6 9.0 1.8
    H2019 Mental Health Behavioral Aide 1 9 36.0 36.0
    T1013 Sign Language or Oral Interpreter Services 139 844 3,112.0 22.4
    T1024 Evaluation and Treatment by Integrated, Specialty Team 4 5 5.0 1.3


    Table 4b. Blue Plus: Types of treatments provided to children with ASD by category of service (n=1,206)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 125 2938 4818 38.5
    053 Speech Therapy 630 15481 15498 24.6
    054 Occupational Therapy 609 16546 43313 71.1


    Table 5a. HealthPartners: Types of treatment provided to children with ASD by procedure code (n=557)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 20 44 44.0 2.2
    90833 Psychotherapy with E&M, 30 minutes 3 16 16.0 5.3
    90834 Psychotherapy, 45 min 48 314 314.0 6.5
    90836 Psychotherapy with E&M, 45 min 1 5 5.0 0.0
    90837 Psychotherapy, 60 min 57 418 418.0 7.3
    90838 Psychotherapy with E&M, 60 min 1 1 1.0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 0 0 0.0 0.0
    90846 Family Psychotherapy - Without Patient Present 166 754 754.0 4.5
    90847 Family Psychotherapy - With Patient Present 111 578 578.0 5.2
    90849 Multiple Family Group Psychotherapy 7 75 75.0 10.7
    90853 Group Psychotherapy 1 5 5.0 5.0
    90887 Interpretation of Psychiatric and Other Medical Examination 3 3 3.0 1.0
    90899 Unlisted Psychiatric Service 23 62 62.0 2.7
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 51 6,813 95,655.0 1,875.6
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 30 2,558 9,832.0 327.7
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 50 2,328 15,390.0 307.8
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 39 581 1,833.0 47.0
    99366 Coordinated Care Conference: Medical Team Conference 3 3 3.0 0.0
    H0031 Administering and Reporting Standardized Measures 163 647 647.0 4.0
    H0032 Individual Treatment Plan Development and Monitoring 150 1,448 1,463.0 9.8
    H2012 Behavioral Health Day Treatment (General Day Treatment) 62 5,911 19,437.0 313.5
    H2014 Skills Training 35 851 8,313.0 237.5
    H2015 Crisis Assistance 1 2 2.0 2.0
    H2019 Mental Health Behavioral Aide 0 0 0.0 0.0
    T1013 Sign Language or Oral Interpreter Services 62 962 4,273.0 68.9
    T1024 Evaluation and Treatment by Integrated, Specialty Team 1 1 1.0 0.0


    Table 5b. HealthPartners: Types of treatment provided to children with ASD by category of service (n=557)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 143 1877 2904 20.3
    053 Speech Therapy 304 8197 8197 27.0
    054 Occupational Therapy 287 7680 20391 71.0


    Table 6a. Hennepin Health: Types of treatment provided to children with ASD by procedure code (n=31)

    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
    90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
    90834 Psychotherapy, 45 min 2 4 4.0 0
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 3 9 9.0 2.0
    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 8 35 35.0 0
    90847 Family Psychotherapy - With Patient Present 4 21 21.0 0
    90849 Multiple Family Group Psychotherapy 0 0 0.0 4.4
    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
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 1 404 3,778.0 0
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 1 357 1,059.0 0
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 1 49 156.0 3,778.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 1 32 119.0 1,059.0
    99366 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 9 41 41.0 119.0
    H0032 Individual Treatment Plan Development and Monitoring 11 197 197.0 0
    H2012 Behavioral Health Day Treatment (General Day Treatment) 6 447 1,328.0 4.6
    H2014 Skills Training 2 249 5,723.0 17.9
    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 4 19 46.0 0
    T1024 Evaluation and Treatment by Integrated, Specialty Team 0 0 0.0 0.0


    Table 6b. Hennepin Health: Types of treatment provided to children with ASD by category of service (n=31)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 5 75 139.0 0
    053 Speech Therapy 19 353 353.0 18.6
    054 Occupational Therapy 15 305 753.0 50.2


    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
    90832 Psychotherapy, 30 min 1 3 3.0 0.0
    90833 Psychotherapy with E&M, 30 minutes 1 8 8.0 0.0
    90834 Psychotherapy, 45 min 1 2 2.0 0.0
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 0 0 0.0 0.0
    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 0 0 0.0 0.0
    90847 Family Psychotherapy - With Patient Present 1 2 2.0 2.0
    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
    99366 Coordinated Care Conference: Medical Team Conference 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 3 6 6.0 0.0
    H0032 Individual Treatment Plan Development and Monitoring 2 8 8.0 4.0
    H2012 Behavioral Health Day Treatment (General Day Treatment) 0 0 0.0 0.0
    H2014 Skills Training 2 139 536.0 268.0
    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
    T1024 Evaluation and Treatment by Integrated, Specialty Team 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 3 52 69.0 23.0
    053 Speech Therapy 8 173 173.0 21.6
    054 Occupational Therapy 9 173 397.0 44.1


    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
    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
    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
    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
    90887 Interpretation of Psychiatric and Other Medical Examination 0 0 0 0.0
    90899 Unlisted Psychiatric Service 0 0 0 0.0
    97153 Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior Identification Assessment 0 0 0.0 0.0
    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
    99366 Family or Caregiver Training and Counseling – Group: Multiple family group adaptive behavior treatment guidance 0 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
    T1024 Evaluation and Treatment by Integrated, Specialty Team 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=131)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 10 43 43.0 4.3
    90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
    90834 Psychotherapy, 45 min 16 73 73.0 4.6
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 22 223 223.0 10.1
    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
    90846 Family Psychotherapy - Without Patient Present 24 57 57.0 2.4
    90847 Family Psychotherapy - With Patient Present 22 134 134.0 6.1
    90849 Multiple Family Group Psychotherapy 1 24 24.0 24.0
    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 1 2 2.0 2.0
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 5 2,129 17,342.0 3,468.4
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 4 437 1,313.0 328.3
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 5 580 3,128.0 625.6
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 5 97 479.0 95.8
    H0031 Administering and Reporting Standardized Measures 13 37 37.0 0.0
    H0032 - CTSS Individual Treatment Plan Development and Monitoring 9 40 40.0 4.4
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring 6 212 212.0 35.3
    H2012 Behavioral Health Day Treatment (General Day Treatment) 1 64 189.0 189.0
    H2014 Skills Training 8 182 1,021.0 127.6
    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
    T1024 Evaluation and Treatment by Integrated, Specialty Team 1 2 2.0 0.0


    Table 9b. PrimeWest: Types of treatment provided to children with ASD by category of service (n=131)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 77 2,103 4,387 57.0
    053 Speech Therapy 20 388 751 37.6
    054 Occupational Therapy 62 1,120 1,120 18.1


    Table 10a. South Country Health Alliance: Types of treatment provided to children with ASD by procedure code (n=64)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 4 23 23.0 5.8
    90833 Psychotherapy with E&M, 30 minutes 1 2 2.0 2.0
    90834 Psychotherapy, 45 min 4 10 10.0 2.5
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 5 95 95.0 19.0
    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 6 8 8.0 1.3
    90847 Family Psychotherapy - With Patient Present 7 19 19.0 2.7
    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 2 2 2.0 1.0
    90899 Unlisted Psychiatric Service 1 1 1.0 1.0
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 6 1,484 11,790.0 1,965.0
    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 6 409 2,271.0 378.5
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 5 65 232.0 46.4
    H0031 Administering and Reporting Standardized Measures 7 19 19.0 0.0
    H0032 - CTSS Individual Treatment Plan Development and Monitoring 6 10 10.0 1.7
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring 6 85 85.0 14.2
    H2012 Behavioral Health Day Treatment (General Day Treatment) 1 5 14.0 14.0
    H2014 Skills Training 4 190 2,792.0 698.0
    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
    T1024 Evaluation and Treatment by Integrated, Specialty Team 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=64)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 19 403 894 47.1
    053 Speech Therapy 2 61 121 60.5
    054 Occupational Therapy 23 396 396 17.2


    Table 11a. UCare: Types of treatments provided to children with ASD by procedure code (n=1,113)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 37 115 115.0 3.1
    90833 Psychotherapy with E&M, 30 minutes 5 25 25.0 5.0
    90834 Psychotherapy, 45 min 75 273 273.0 3.6
    90836 Psychotherapy with E&M, 45 min 1 3 3.0 0.0
    90837 Psychotherapy, 60 min 106 528 528.0 5.0
    90838 Psychotherapy with E&M, 60 min 1 1 1.0 0.0
    90839 Psychotherapy for Crisis, first 60 minutes 3 4 4.0 1.3
    90846 Family Psychotherapy - Without Patient Present 286 1,679 1,679.0 5.9
    90847 Family Psychotherapy - With Patient Present 180 755 755.0 4.2
    90849 Multiple Family Group Psychotherapy 13 84 84.0 6.5
    90853 Group Psychotherapy 0 0 0.0 0.0
    90887 Interpretation of Psychiatric and Other Medical Examination 6 6 6.0 1.0
    90899 Unlisted Psychiatric Service 41 94 99.0 2.4
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 131 25,188 252,414.0 1,926.8
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 66 9,058 25,686.0 389.2
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 121 6,996 42,064.0 347.6
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 92 1,262 7,798.0 84.8
    H0031 Administering and Reporting Standardized Measures 364 1,506 1,507.0 0.0
    H0032 - CTSS Individual Treatment Plan Development and Monitoring 218 884 960.0 4.4
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring 130 2,148 2,250.0 17.3
    H2012 Behavioral Health Day Treatment (General Day Treatment) 156 13,928 41,398.0 265.4
    H2014 Skills Training 118 4,711 108,707.0 921.2
    H2015 Crisis Assistance 3 4 67.0 22.3
    H2019 Mental Health Behavioral Aide 0 0 0.0 0.0
    T1013 Sign Language or Oral Interpreter Services 233 3,833 12,779.0 54.8
    T1024 Evaluation and Treatment by Integrated, Specialty Team 2 2 2.0 0.0


    Table 11b. UCare: Types of treatments provided to children with ASD by category of service (n=1,113)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    051 Physical Therapy 539 13,115 35,647 66.1
    053 Speech Therapy 89 1,618 2,582 29.0
    054 Occupational Therapy 608 14,508 14,522 23.9


    Notes

    • Data are limited to final version Minnesota Health Care Programs (MHCP) paid claims with service dates between Jan. 1, 2021, and Dec. 31, 2021, 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, 2021.
    • 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 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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