(DURABLE MEDICAL EQUIPMENT AND SUPPLIES)
Assistive technology device means any item, piece of equipment or product system, whether a vendor stock item, modified or customized, that is used to increase, maintain or improve the developmental capabilities of children with disabilities. Authorization to obtain assistive technology devices is based upon prior approval. The request for authorization to obtain an assistive technology device must be accompanied by: 1) a physician prescription and certification of medical/developmental necessity under the above conditions; and 2) an assistive technology evaluation by an occupational, physical, or speech therapist or audiologist indicating the child's needs, completed no earlier than six months prior to the request for the assistive technology and must be identified as a need in the family's Service Plan. It is recommended that lending libraries be utilized to meet the short-term needs of infants and toddlers eligible for this program for the purpose of acquiring/using toys and other equipment which may or may not be adapted for the child. Linking the provision of the device to an education benefit is not appropriate. Assistive technology devices are covered only if they relate to the developmental needs of the infants and toddlers served by the program. Early intervention does not cover provision of assistive technology devices to meet the medical, life sustaining, or routine daily needs of a child.
Assistive technology service means a service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device. Assistive technology services include 1) determining the durable medical equipment and supply needs of a child with a disability; 2) purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by children with disabilities; 3) selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices; 4) coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing rehabilitation plans and programs; 5) training or technical assistance for a child with disabilities or, if appropriate, that child's family; and 6) training or technical assistance for professionals (including individuals providing early intervention services) or other individuals who provide services to or are otherwise substantially involved in the major life functions of the child. Assistive technology services rendered by enrolled durable medical equipment and supplies providers are included in the cost of the device. Assistive technology evaluation services rendered by other qualified providers should be billed under the service description for their discipline.
Services must be consistent with the provider's qualifications and licensure.
NOTE: All providers of assistive technology services are required to provide the equipment to the child/family prior to submitting a claim for services to insurance or to the CBO. Early Intervention is a fee-for-service system. In a fee-for-service system the service must be provided prior to billing for the service.
Early Intervention System enrolled durable medical equipment and supplies providers. (See ATTACHMENT 5: REQUIREMENTS FOR PROFESSIONAL AND ASSOCIATE LEVEL EARLY INTERVENTION CREDENTIALING AND ENROLLMENT TO BILL)
Billable Activities With Authorization:
Purchasing, leasing, or otherwise providing the acquisition of assistive technology devices and providing related assistive technology services.
Do not provide services without having an authorization in hand. Services provided without a pre-approved authorization are not guaranteed for payment.
||Unit of Service
||Customary Review Parameters
|Bill using HCPCS National Level II codes for assistive technology devices at quantity and rate posted on prior approval.
Bill using HCPCS National Level II codes for assistive technology devices at quantity and rate posted on prior approval.
NOTES: 1) When a provider bills the CBO for the procedure code E1399 a description of the equipment must be included on the claim form; 2) Please see ATTACHMENT 9: EARLY INTERVENTION PUBLIC AND PRIVATE INSURANCE USE DETERMINATION GUIDELINES for information on the responsibilities of the provider to document insurance benefits verification and billing as required by EI policy: and 3) Please see ATTACHMENT 11: EARLY INTERVENTION ASSISTIVE TECHNOLOGY GUIDELINES.