Service Description: Physical therapy services to address the promotion of sensorimotor function through enhancement of musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and effective environmental adaptation. These services include:

  1. Evaluation and assessment of infants and toddlers to identify movement dysfunction; (global evaluation not acceptable)
  2. Obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and
  3. Providing individual and group services or treatment to prevent, alleviate, or compensate for movement dysfunction and related functional problems.

Activities also include IFSP development and assistive technology assessment, if needed, and environmental consultation to ensure that appropriate adaptations and safety issues for the eligible child are incorporated.

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 physical therapy 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.

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

NOTE: Early Intervention does not pay for therapeutic services required due to, or as part of, a medical procedure, a medical intervention or an injury. Acute rehabilitative therapy and therapy required as part of a medical procedure, medical intervention or injury, is not developmentally based but is medically based. Once the condition has become chronic or sub-acute the therapy for the on-going developmental delay can be provided by EI.

Qualified Staff: 1) System enrolled Specialist credentialed as a Licensed Physical Therapist or 2) a non-enrolled Associate credentialed as a Licensed Physical Therapy Assistant. Assistants must work under the supervision of an enrolled Licensed Physical Therapist. (See ATTACHMENT 4: USE OF ASSOCIATE LEVEL PROVIDERS for more detail. 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 With Authorization: IFSP development definition) and direct services.

NOTE: Bill for time required to develop assistive technology requests using IFSP development code.

PHYSICAL THERAPY - cont.

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

Physical Therapy

Procedure Codes Modifiers Unit of Service Description Rate
97001 15 minutes Evaluation / Assessment - onsite $14.11
97001 15 minutes Evaluation / Assessment - offsite $17.61
99271 SE 15 minutes IFSP development $14.11
99271 SE 15 minutes IFSP meeting $17.61
97110 15 minutes Individual therapy - onsite $14.11
97110 15 minutes Individual therapy - offsite $17.61
97150 SE 15 minutes Group therapy (multiple families or group not to exceed 4 children) $ 7.65