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    Data from 2022 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 464 1,967
    HealthPartners 279 948
    Hennepin Health 14 34
    Itasca Medical Care 7 57
    Medica 2 5
    PrimeWest 64 278
    South Country Health Alliance 25 140
    Ucare 457 1,660
    United Healthcare 22 101
    MCOs Overall 1,334 5,190


    Table 2a. 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 1,153 834
    HealthPartners 742 591
    Hennepin Health 42 30
    Itasca Medical Care 25 14
    Medica 9 8
    PrimeWest 122 97
    South Country Health Alliance 92 47
    Ucare 1,496 1,134
    United Healthcare 99 63
    MCOs Overall 3,780 2,818


    Table 2b. Number of children (1-6 years old) who received a diagnostic assessment, by procedure code and age

    Procedure code Number of children (1-3 years old) Number of children (4-6 years old)
    90785 495 2,129
    90791 1017 4,269
    90792 14 170
    90887 12 94
    96116 15 87
    96130 345 847
    96138 142 317
    96146 0 11
    97151 222 413


    Table 2c. Number of children (1-6 years old) who received a diagnostic assessment, by procedure code and MCO

    MCO 90785 90791 90792 90887 96116 96130 96138 96146 97151
    Blue Plus 6,182 2,408 93 48 42 460 149 3 709
    HealthPartners 3,257 1,194 37 10 26 248 84 1 351
    Hennepin Health 100 44 0 1 0 14 9 0 25
    Itasca Medical Care 208 47 8 15 8 5 5 0 13
    Medica 4 3 0 0 0 2 0 0 0
    PrimeWest 1,308 329 18 3 0 74 13 4 96
    South Country Health Alliance 352 157 5 3 3 20 6 0 46
    UCare 4,942 2,046 41 30 64 497 209 5 786
    United Healthcare 221 112 1 2 4 28 9 0 89
    MCOs Overall 16,574 6,340 203 112 147 1,348 484 13 2,115


    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 5 3 106 76 210 158
    HealthPartners 3 3 60 53 155 128
    Hennepin Health 1 1 3 2 9 8
    Itasca Medical Care 0 0 1 1 8 6
    Medica 1 1 1 0 2 2
    PrimeWest 2 1 5 4 21 17
    South Country Health Alliance 0 0 5 3 19 12
    UCare 12 7 126 94 286 229
    United Healthcare 0 0 8 5 17 10
    MHCP Overall 24 16 315 238 727 570


    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 279 206 258 196 295 195
    HealthPartners 169 139 175 136 180 132
    Hennepin Health 12 8 6 4 11 7
    Itasca Medical Care 4 2 9 4 3 1
    Medica 0 0 2 2 3 3
    PrimeWest 28 22 31 25 35 28
    South Country Health Alliance 21 12 21 9 26 11
    Ucare 327 264 368 280 377 260
    United Healthcare 20 14 24 17 30 17
    MHCP Overall 860 667 894 673 960 654


    Table 4a. Blue Plus: Types of treatments provided to children with ASD by procedure code (n=1,153)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 51 119 119.0 2.3
    90833 Psychotherapy with E&M, 30 minutes 17 53 53.0 3.1
    90834 Psychotherapy, 45 min 92 290 290.0 3.2
    90836 Psychotherapy with E&M, 45 min 1 1 1.0 1.0
    90837 Psychotherapy, 60 min 134 737 737.0 5.5
    90838 Psychotherapy with E&M, 60 min 1 2 2.0 2.0
    90839 Psychotherapy for Crisis, first 60 minutes 2 2 2.0 1.0
    90846 Family Psychotherapy - Without Patient Present 161 974 974.0 6.0
    90847 Family Psychotherapy - With Patient Present 168 728 728.0 4.3
    90849 Multiple Family Group Psychotherapy 2 33 33.0 16.5
    90853 Group Psychotherapy 4 44 44.0 11.0
    90887 Interpretation of Psychiatric and Other Medical Examination 8 8 8.0 1.0
    90899 Unlisted Psychiatric Service 31 65 65.0 2.1
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 140 32,854 295,607.0 2,111.5
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 67 6,227 18,388.0 274.4
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 137 10,258 67,335.0 491.5
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 115 1,203 4,398.0 38.2
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 2 3 9.0 4.5
    99499 Unlisted Evaluation and Management Service 1 1 1.0 1.0
    H0031 Administering and Reporting Standardized Measures 223 606 606.0 2.7
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 143 413 492.0 3.4
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 160 4,533 4,775.0 29.8
    H2012 Behavioral Health Day Treatment (General Day Treatment) 52 4,494 13,268.0 255.2
    H2014 Skills Training 79 2,018 29,970.0 379.4
    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 108 652 2,506.0 23.2
    T1024 Evaluation and Treatment by Integrated, Specialty Team 46 116 154.0 3.3


    Table 4b. Blue Plus: Types of treatments provided to children with ASD by category of service (n=1,153)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    054 Occupational Therapy 539 14,681 36,210 67.2
    051 Physical Therapy 115 2,211 3,910.0 34.0
    053 Speech Therapy 555 14,218 14,228.0 25.6


    Table 5a. HealthPartners: Types of treatment provided to children with ASD by procedure code (n=742)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 31 68 68.0 2.2
    90833 Psychotherapy with E&M, 30 minutes 3 10 10.0 3.3
    90834 Psychotherapy, 45 min 50 287 287.0 5.7
    90836 Psychotherapy with E&M, 45 min 1 2 2.0 2.0
    90837 Psychotherapy, 60 min 67 294 294.0 4.4
    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
    90846 Family Psychotherapy - Without Patient Present 181 788 788.0 4.4
    90847 Family Psychotherapy - With Patient Present 130 635 635.0 4.9
    90849 Multiple Family Group Psychotherapy 9 83 83.0 9.2
    90853 Group Psychotherapy 3 7 7.0 2.3
    90887 Interpretation of Psychiatric and Other Medical Examination 2 2 2.0 1.0
    90899 Unlisted Psychiatric Service 17 39 40.0 2.4
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 81 20,595 197,702.0 2,440.8
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 55 8,779 24,179.0 439.6
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 79 5,684 32,542.0 411.9
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 59 846 2,833.0 48.0
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 0 0 0.0 0.0
    99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 192 593 593.0 3.1
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 110 306 306.0 2.8
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 97 2,388 2,413.0 24.9
    H2012 Behavioral Health Day Treatment (General Day Treatment) 75 6,036 17,847.0 238.0
    H2014 Skills Training 38 284 1,469.0 38.7
    H2015 Crisis Assistance 2 2 2.0 1.0
    H2019 Mental Health Behavioral Aide 1 26 208.0 208.0
    T1013 Sign Language or Oral Interpreter Services 82 890 3,654.0 44.6
    T1024 Evaluation and Treatment by Integrated, Specialty Team 13 93 104.0 8.0


    Table 5b. HealthPartners: Types of treatment provided to children with ASD by category of service (n=742)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    054 Occupational Therapy 411 12,456 22,325 54.3
    051 Physical Therapy 306 14,863 15,556.0 50.8
    053 Speech Therapy 420 12,626 12,629.0 30.1


    Table 6a. Hennepin Health: Types of treatment provided to children with ASD by procedure code (n=42)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 2 3 3.0 1.5
    90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
    90834 Psychotherapy, 45 min 6 21 21.0 3.5
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 5 16 16.0 3.2
    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
    90846 Family Psychotherapy - Without Patient Present 16 87 87.0 5.4
    90847 Family Psychotherapy - With Patient Present 11 57 57.0 5.2
    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 1 1 1.0 1.0
    90899 Unlisted Psychiatric Service 1 1 1.0 1.0
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 5 884 9,023.0 1,804.6
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 3 719 2,091.0 697.0
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 4 138 535.0 133.8
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 3 34 107.0 35.7
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 0 0 0.0 0.0
    99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 18 63 63.0 3.5
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 13 210 210.0 16.2
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 4 70 78.0 19.5
    H2012 Behavioral Health Day Treatment (General Day Treatment) 6 555 1,638.0 273.0
    H2014 Skills Training 3 248 6,885.0 2,295.0
    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 8 65 183.0 22.9
    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=42)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    054 Occupational Therapy 24 489 1,279 53.3
    051 Physical Therapy 4 207 333.0 83.3
    053 Speech Therapy 26 457 457.0 17.6


    Table 7a. Itasca Medical Care: Types of treatment provided to children with ASD by procedure code (n=25)

    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 2 6 6.0 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 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 1 2 7.0 7.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 1 48 212.0 212.0
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 0 0 0.0 0.0
    99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 1 2 2.0 2.0
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 3 4 4.0 1.3
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 1 37 37.0 37.0
    H2012 Behavioral Health Day Treatment (General Day Treatment) 0 0 0.0 0.0
    H2014 Skills Training 3 51 406.0 135.3
    H2015 Crisis Assistance 1 1 1.0 1.0
    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=25)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    054 Occupational Therapy 8 173 339 42.4
    051 Physical Therapy 6 86 150.0 25.0
    053 Speech Therapy 11 188 188.0 17.1


    Table 8a. Medica: Types of treatment provided to children with ASD by procedure code (n=9)

    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 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 3 14 14.0 4.7
    90847 Family Psychotherapy - With Patient Present 1 1 1.0 1.0
    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 1 41 362.0 362.0
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 1 34 196.0 196.0
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 1 5 21.0 21.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 0 0 0.0 0.0
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 0 0 0.0 0.0
    99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 0 0 0.0 0.0
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 1 1 1.0 1.0
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 0 0 0.0 0.0
    H2012 Behavioral Health Day Treatment (General Day Treatment) 1 18 54.0 54.0
    H2014 Skills Training 1 18 60.0 60.0
    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 8b. Medica: Types of treatment provided to children with ASD by category of service (n=9)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    054 Occupational Therapy 5 80 280 56.0
    051 Physical Therapy 0 0 0.0 0.0
    053 Speech Therapy 5 114 114.0 22.8


    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
    90832 Psychotherapy, 30 min 5 8 8.0 1.6
    90833 Psychotherapy with E&M, 30 minutes 1 1 1.0 1.0
    90834 Psychotherapy, 45 min 18 34 34.0 1.9
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 14 152 152.0 10.9
    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 14 50 50.0 3.6
    90847 Family Psychotherapy - With Patient Present 13 51 51.0 3.9
    90849 Multiple Family Group Psychotherapy 1 2 2.0 2.0
    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 2 2 2.0 1.0
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 10 3,929 22,645.0 2,264.5
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 2 392 1,777.0 888.5
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 10 1,928 7,995.0 799.5
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 7 108 437.0 62.4
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 1 1 3.0 3.0
    99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 13 35 35.0 2.7
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 6 10 10.0 1.7
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 13 508 508.0 39.1
    H2012 Behavioral Health Day Treatment (General Day Treatment) 0 0 0.0 0.0
    H2014 Skills Training 6 76 411.0 68.5
    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
    T1024 Evaluation and Treatment by Integrated, Specialty Team 2 17 17.0 8.5


    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
    054 Occupational Therapy 62 1,523 3,036 49.0
    051 Physical Therapy 19 425 678.0 35.7
    053 Speech Therapy 52 893 893.0 17.2


    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
    90832 Psychotherapy, 30 min 3 3 3.0 1.0
    90833 Psychotherapy with E&M, 30 minutes 1 3 3.0 3.0
    90834 Psychotherapy, 45 min 5 13 13.0 2.6
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 7 93 93.0 13.3
    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
    90846 Family Psychotherapy - Without Patient Present 11 24 24.0 2.2
    90847 Family Psychotherapy - With Patient Present 11 85 85.0 7.7
    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 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 8 4,179 35,279.0 4,409.9
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 1 1 6.0 6.0
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 8 1,013 6,168.0 771.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 8 86 283.0 35.4
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 0 0 0.0 0.0
    99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 9 24 24.0 2.7
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 9 20 20.0 2.2
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 12 448 472.0 39.3
    H2012 Behavioral Health Day Treatment (General Day Treatment) 2 49 147.0 73.5
    H2014 Skills Training 8 121 606.0 75.8
    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 1 1 7.0 7.0
    T1024 Evaluation and Treatment by Integrated, Specialty Team 9 41 41.0 4.6


    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
    054 Occupational Therapy 20 343 794 39.7
    051 Physical Therapy 3 40 100.0 33.3
    053 Speech Therapy 25 487 487.0 19.5


    Table 11a. UCare: Types of treatments provided to children with ASD by procedure code (n=1,496)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 50 165 166.0 3.3
    90833 Psychotherapy with E&M, 30 minutes 10 27 27.0 2.7
    90834 Psychotherapy, 45 min 102 402 402.0 3.9
    90836 Psychotherapy with E&M, 45 min 3 4 4.0 1.3
    90837 Psychotherapy, 60 min 125 721 721.0 5.8
    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
    90846 Family Psychotherapy - Without Patient Present 267 1,450 1,450.0 5.4
    90847 Family Psychotherapy - With Patient Present 197 653 656.0 3.3
    90849 Multiple Family Group Psychotherapy 16 178 178.0 11.1
    90853 Group Psychotherapy 2 8 8.0 4.0
    90887 Interpretation of Psychiatric and Other Medical Examination 5 5 5.0 1.0
    90899 Unlisted Psychiatric Service 48 121 121.0 2.5
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 205 49,676 483,985.0 2,360.9
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 103 17,298 49,273.0 478.4
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 196 15,035 91,356.0 466.1
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 161 3,642 24,907.0 154.7
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 5 11 32.0 6.4
    99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 372 1214 1,214.0 3.3
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 213 750 763.0 3.6
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 224 5,337 5,888.0 26.3
    H2012 Behavioral Health Day Treatment (General Day Treatment) 154 14,313 42,161.0 273.8
    H2014 Skills Training 103 4,077 100,330.0 974.1
    H2015 Crisis Assistance 2 5 5.0 2.5
    H2019 Mental Health Behavioral Aide 0 0 0.0 0.0
    T1013 Sign Language or Oral Interpreter Services 337 4,555 14,930.0 44.3
    T1024 Evaluation and Treatment by Integrated, Specialty Team 27 60 101.0 3.7


    Table 11b. UCare: Types of treatments provided to children with ASD by category of service (n=1,496)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    054 Occupational Therapy 703 19,987 56,775 80.8
    051 Physical Therapy 149 3,789 5,759.0 38.7
    053 Speech Therapy 751 20,000 20,031.0 26.7


    Table 12a. United Healthcare: Types of treatments provided to children with ASD by procedure code (n=99)

    Procedure code Description Unique # of children who receive service Count of services Total units submitted Average units
    90832 Psychotherapy, 30 min 3 22 22.0 7.3
    90833 Psychotherapy with E&M, 30 minutes 0 0 0.0 0.0
    90834 Psychotherapy, 45 min 6 23 23.0 3.8
    90836 Psychotherapy with E&M, 45 min 0 0 0.0 0.0
    90837 Psychotherapy, 60 min 4 18 18.0 4.5
    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
    90846 Family Psychotherapy - Without Patient Present 14 41 41.0 2.9
    90847 Family Psychotherapy - With Patient Present 14 42 42.0 3.0
    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 0 0 0.0 0.0
    90899 Unlisted Psychiatric Service 1 5 5.0 5.0
    97153 EIDBI Intervention – Individual: Adaptive behavior treatment by protocol 11 3,292 27,371.0 2,488.3
    97154 EIDBI Intervention – Group: Group adaptive behavior treatment by protocol 7 1,646 4,952.0 707.4
    97155 Intervention - Individual: Observation and Direction: Adaptive behavior treatment with protocol modification 9 962 4,500.0 500.0
    97156 Family/Caregiver Training and Counseling: Individual: Family adaptive behavior treatment guidance 8 131 497.0 62.1
    97157 Multiple Family Group Adaptive Behavior Treatment Guidance 0 0 0.0 0.0
    99499 Unlisted Evaluation and Management Service 0 0 0.0 0.0
    H0031 Administering and Reporting Standardized Measures 26 86 86.0 3.3
    H0032 - CTSS Individual Treatment Plan Development and Monitoring (Children’s Therapeutic Services & Supports) 13 24 24.0 1.8
    H0032 - EIDBI Individual Treatment Plan Development and Monitoring (Early Intensive Developmental and Behavioral Intervention) 10 247 249.0 24.9
    H2012 Behavioral Health Day Treatment (General Day Treatment) 7 536 1,591.0 227.3
    H2014 Skills Training 6 45 106.0 17.7
    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 15 274 773.0 51.5
    T1024 Evaluation and Treatment by Integrated, Specialty Team 1 1 1.0 1.0


    Table 12b. United Healthcare: Types of treatments provided to children with ASD by category of service (n=99)

    Category of service Description Unique # of children who receive service Count of services Total units submitted Average units
    054 Occupational Therapy 44 820 2,185 49.7
    051 Physical Therapy 2 23 62.0 31.0
    053 Speech Therapy 45 906 906.0 20.1


    Notes

    • Data are limited to final version Minnesota Health Care Programs (MHCP) paid claims with service dates between Jan. 1, 2022, and Dec. 31, 2022, 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, 2022.
    • 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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