Interpretation

  • Interpreters must indicate the type of service provided in box 23 of the HCFA/CMS-1500 whether billed electronically or on paper.
  • If billing electronically, multiple disciplines can not be listed in box 23. All service lines must be for the same discipline. If the provider is interpreting more than one discipline type, each should be billed on a separate form.
  • When billing on paper, multiple disciplines can be listed in box 23. A comma should separate each discipline which will indicate the next line of service.
  • If multiple disciplines need to be listed for one line of service indicate this by using a back slash between them as shown below. Example: PT, ST, OT, IM, DT, PT/ST
  • Claims that do not include the type of service interpreted will be denied.
  • Some description examples are as follows:
    • PT = Physical Therapy
    • OT = Occupational Therapy
    • ST = Speech Therapy
    • DT = Developmental Therapy
    • PS = Psychological Services
    • SW = Social Work
    • AU = Audiology
    • AR = Aural Rehabilitation
    • TI = Translation of the IFSP report
    • PT = Physical Therapy Evaluation (Same for all disciplines)
    • IM = IFSP Meeting (Same for all disciplines)
    • PT/OT = Physical Therapy & Occupational Therapy
  • When billing on paper only - If you feel more specific information should be reported to avoid possible denial you may include this at the end of each service line in box 24K.

Please go to http://www.EICBO.info for more detailed information or call the EI-CBO for technical assistance if needed.

Initial Evaluation / Assessment Services

  • Evaluation/assessment services for the purpose of determining initial eligibility, participating in the development of an initial comprehensive IFSP, and adding new types of service to existing IFSP's must be provided by a provider with a credential for Evaluation/Assessment in addition to an Early Intervention Specialist credential in the discipline required by the service being evaluated.
  • IFSP meeting attendance is required in order to be paid for the evaluations used to determine eligibility. The evaluation and IFSP meeting should be billed on the same claim and must be authorized. If no meeting was held and the case is closed the evaluation claim will be paid. If a meeting was held but the provider was unable to attend, a letter from the CFC manager needs to be attached to the claim for payment approval.
  • For children with an active IFSP, regardless of referral date, credentialed evaluators must be used to determine the child's need for newly identified services.
  • You must bill the EI-CBO for Evaluation/Assessment, IFSP development, audiological exams and Medical Services for diagnostic/evaluation purposes. These services are not billable to insurance or directly to families.