Service Description

Service Description: Nursing services for the purposes of:

  1. Global evaluation to determine a child's developmental status and need for early intervention services (See DEFINITIONS section for additional information);
  2. Assessment to determine a child's health status, including the identification of patterns of human response to actual or potential health problems and the identification of the need for medical referrals;
  3. Provision of nursing care during the time the child is receiving other early intervention services in a clinic based setting that may be required to allow the child to participate in EI services such as:
    • administration of medications, treatments, and regimens prescribed by a licensed physician; and
    • clean intermittent catheterization, tracheostomy care, tube feeding, the changing of dressings or colostomy collection bags, and other health services as required to allow the child to participate in EI services.
  4. Does not include hospital or home health nursing care required due to surgical or medical intervention, or an injury, or medical-health services such as immunizations and regular well-baby care that are routinely recommended for all children.

Family training, education and support provided to assist the family of a child eligible for services in understanding the special needs of the child as related to nursing services and enhancing the child's development are integral to this service. Eligible child is not required to be present but may be if appropriate. May include such services as support groups, individual support and other training or education for the family.

NOTE: The need for nursing services does not determine eligibility for the Early Intervention program.

Services must be consistent with the provider's qualifications and licensure.

Qualified Staff: System enrolled Specialist credentialed as a Licensed Registered Nurse. (See ATTACHMENT 5: REQUIREMENTS FOR PROFESSIONAL AND ASSOCIATE LEVEL EARLY INTERVENTION CREDENTIALING AND ENROLLMENT TO BILL.)

Billable Activities Evaluation / assessment, IFSP development (see DEFINITIONS section for Authorization  IFSP development definition) and direct service.

Do not provide services without having an authorization in hand. Services provided without a pre-approved authorization are not guaranteed for payment.

Nursing

Procedure Codes Modifier Unit of Service Description Rate
T1001 15 minutes Evaluation / Assessment- onsite $11.39
T1001 15 minutes Evaluation / Assessment - offsite $14.36
99272 15 minutes IFSP development $11.39
99272 15 minutes IFSP meeting $14.36
T1002 15 minutes Nursing services - onsite $11.39
T1002 15 minutes Nursing services - offsite $14.36
T1002 HQ 15 minutes Group Nursing services (multiple families or group not to exceed 4 children) $ 2.85

See "

Nutrition

" for additional service activities and billing codes.