Due Process Hearing. You have the right to file a due process hearing request when there is a disagreement regarding the proposal to initiate or change, or refusal to initiate or change the identification, evaluation, or placement of your child, the provision of appropriate early intervention services to your child or family, or to challenge information in the Early Steps record to ensure that it is not inaccurate, misleading, or otherwise in violation of the privacy or other rights of your child. A due process hearing request must be filed with the Florida Department of Health, Children’s Medical Services, Early Steps State Office at: The party submitting a due process hearing request, or their attorney, must ensure the other party receives a copy of the hearing request, which must remain confidential. A due process hearing request must include the following: • name of your child; • the address of the residence of your child; • the name of the early intervention provider serving your child; • a description of the nature of the problem of your child relating to the proposed or refused initiation or change, including facts relating to the problem; • a proposed resolution of the problem to the extent known and available to you at the time; and • an allegation that the action forming the basis for the due process complaint occurred within 2 years of the date you Early Steps or the provider knew (or should have known) about the alleged action. Within 10 days of a due process hearing request, you will receive a written response from the other party addressing each issue you raised in your due process hearing request. If you have not received prior written notice regarding the issues addressed in your due process hearing request, then the response will also include the following: • an explanation of why Early Steps proposed or refused to take the action raised in the due process hearing request; • a description of other options that the IFSP team considered and the reasons why those options were rejected; • a description of each evaluation procedure, assessment, record, or report used as the basis for the proposed or refused action; and • a description of the other factors relevant to the proposed or refused action. The hearing officer will determine the sufficiency of a due process hearing request. Either party may challenge the sufficiency of the due process hearing request by filing a written claim with the hearing officer within 15 days of the hearing request. Within 5 days of receipt of the challenge, the hearing officer will issue a ruling on the sufficiency of the due process hearing request. Mediation will be offered when a due process hearing request is received and you will be notified of free or low cost legal and other relevant advocacy services that are available. The Early Steps State Office will conduct a resolution meeting within 15 days of the receipt of a due process hearing request with the parent(s) and the relevant IFSP team members, as agreed by both parties. The purpose of the resolution meeting is to allow the Early Steps State Office the opportunity to resolve the issues in the due process hearing request. The Early Steps State Office may not bring an attorney unless you bring an attorney. If you file a due process hearing request and do not participate in the resolution meeting after reasonable efforts by the Early Steps State Office, your due process hearing request may be dismissed. If the Early Steps State Office does not hold or participate in a resolution meeting within 15 days of receipt of the hearing request, you may request the hearing officer to initiate the 45 day due process timeline. The 45 day due process hearing timeline begins after: • both parties agree in writing to waive the resolution meeting or seek mediation; • after the resolution meeting or mediation starts but before the end of the 30 day period and the parties agree in writing that no agreement is possible; or • both parties agree in writing to continue the resolution or meditation process at the end of the 30 day period but later withdraws. If a resolution to the dispute is reached at the resolution meeting, a legally binding agreement is written that is signed by both parties and enforceable in federal or state court. Either party may void the agreement within 3 business days of execution. The Early Steps State Office may use methods to seek enforcement of a written agreement resulting from a mediation or resolution meeting as long as those mechanisms are not mandatory and does not delay or deny the parents right to seek enforcement of the written agreement in a federal or state court. A party may amend a due process hearing request if either the other party consents in writing to the amendment and is given the opportunity to resolve the issues in the due process hearing request through a resolution meeting or the hearing officer grants permission not later than five days before the due process hearing is scheduled. If a party files an amended due process hearing request, the 30 day timeline for the resolution meeting begins again with the filing of the amended due process hearing request. A due process hearing is conducted by an impartial person who is not an employee of Early Steps, or any other entity involved in the services or care for your child, though Early Steps pays for their services. They do not have a personal or professional interest that would conflict with their ability to be objective and implement the process. The hearing officer will have knowledge about Early Steps, including Part C of the Individuals with Disabilities Education Act, applicable federal and state regulations, and legal interpretations by federal and state courts. The officer will listen to relevant viewpoints about the issue, examine all information related to the issues, seek to reach a timely resolution regarding the issue, and make decisions based on substantive grounds. It will be at a time and place that is convenient to you and you will be notified of the date, time, and place of the hearing in a reasonable time in advance. A hearing will be held and a written decision mailed within 45 days of the request of a hearing. The written decision will be based on the evidence and will include a summary of the evidence and the reasons for the decision. During a due process hearing, you have the right to: • be accompanied and advised by counsel and by individuals with special knowledge or training on Early Steps at your own expense; • present evidence and confront, cross examine, and require attendance of witnesses; • not allow evidence that has not been disclosed to you at least five days before the hearing; • receive a written or electronic (based on your preference) word for word copy of the hearing at no cost; • receive a written or electronic (based on your preference) findings and decisions from the hearing at no cost; and • request the hearing be open to the public (it will be closed unless the parties request it be open). Parties involved in the due process hearing must disclose all evaluations and recommendations at least 5 business days before the proceeding. The hearing officer may bar any party that fails to comply without the consent of the other party. The party requesting a due process hearing may not raise issues at the due process hearing that were not raised in the due process complaint unless the other party agrees. In matters alleging a procedural violation, a hearing officer may find that your child was not appropriately identified, evaluated, placed, or provided early intervention services only if it: • Impeded your child’s right to identification, evaluation, and placement or provision of early intervention services for your child and family; • Significantly impeded the your opportunity to participate in the decision-making process regarding identification, evaluation, placement or provision of early intervention services for your child and family; or • Caused a deprivation of developmental benefit. Unless you and Early Steps agree, Early Steps will continue to provide the early intervention services to which you have provided consent or if applying for initial services, will provide the early intervention services not in dispute as authorized on your Individualized Family Support Plan (IFSP). A decision made in a due process hearing is final, except that either party may file a civil action. This must be done in state or federal court within 90 days of the due process decision. In a civil action, the court will receive the records of the due process hearing, hear additional evidence at the request of a party, and grant the relief the court determines to be appropriate, based on the preponderance of the evidence. Parents also have rights, procedures, and remedies available under the Constitution, Americans With Disabilities Act, title V of the Rehabilitation Act, and other federal laws protecting the rights of children with disabilities. EXHIBIT B – STATEMENT OF UNDERSTANDING OF PART C PROCEDURAL SAFEGUARDS Department of Pediatrics Gainesville, FL 32610 North Central Early Steps PH: ▇▇▇-▇▇▇-▇▇▇▇/▇-▇▇▇ ▇▇▇-▇▇▇▇ FAX: ▇▇▇-▇▇▇-▇▇▇▇ An Equal Opportunity Institution EXHIBIT C – HOMELAND SECURITY STATEMENT Exhibit D ASST AT ASSISTIVE TECHNOLOGY T1999 T1999 EACH ITEM N/A $ 5,000.00 EACH ITEM TPIN and/or MED. If EOB or no coverage, CONT Rate TBD, not auto calculated ASTE AT ASSISTIVE TECHNOLOGY EVAL 97755 97755 1 EVAL $ 48.50 $ 48.50 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT COIFF All IFSP CONSULT, PROF, FACE-TO-FACE n/a COIFF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT COIFF All IFSP CONSULT, PROF, FACE-TO-FACE via Telemedicine n/a COIFFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT COIFP All IFSP CONSULT, PROF, BY PHONE n/a COIFP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT CONIF EI CONSULT FACE-TO-FACE, ITDS n/a CONIF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONIF EI CONSULT FACE-TO-FACE, ITDS via Telemedicine n/a CONIFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONIP EI CONSULT, PHONE, ITDS n/a CONIP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT EIGF EI EI GROUP SESSION BY EI PROF T1027TT T1027TTSC 1 HOUR $ 25.00 $ 25.00 1 HOUR MED if primary or secondary. CONT if only TPIN. EIIF EI EI INDIVIDUAL SESSION BY EI PROF T1027SC T1027SC 1 HOUR $ 50.00 $ 50.00 1 HOUR MED if primary or secondary. CONT if only TPIN. EIIF EI EI INDIVIDUAL SESSION BY EI PROF via Telemedicine T1027SCGT T1027SCGT 1 HOUR $ 50.00 $ 50.00 1 HOUR MED if primary or secondary. CONT if only TPIN. CONOF OT CONSULT FACE-TO-FACE, OT n/a CONOF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONPF PT CONSULT FACE-TO-FACE, PT n/a CONPF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONSF Speech CONSULT FACE-TO-FACE, ST n/a CONSF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONOF OT CONSULT FACE-TO-FACE, OT via Telemedicine n/a CONOFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONPF PT CONSULT FACE-TO-FACE, PT via Telemedicine n/a CONPFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONSF Speech CONSULT FACE-TO-FACE, ST via Telemedicine n/a CONSFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONOP OT CONSULT, PHONE, OT n/a CONOP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT CONPP PT CONSULT, PHONE, PT n/a CONPP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT CONSP Speech CONSULT, PHONE, ST n/a CONSP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT EXIT All EXIT ASSESSMENT n/a EXIT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT INTR Interpreter INTERPRETER T1013 T1013 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT IPDEF EI F/U PSYCH AND DEV EVAL BY EI PROF T1024TLTS T1024TLTS 1 HOUR $ 75.00 $ 150.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEF EI F/U PSYCH AND DEV EVAL BY EI PROF via Telemedicine T1024TLTSGT T1024TLTSG 1 HOUR $ 75.00 $ 150.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEF EI F/U PSYCH AND DEV EVAL BY ITDS T1024TS T1024TS 1 HOUR $ 55.50 $ 111.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEF EI F/U PSYCH AND DEV EVAL BY ITDS via Telemedicine T1024TSGT T1024TSGT 1 HOUR $ 55.50 $ 111.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEI EI INITIAL PSYCH AND ▇▇▇ EVAL BY EI PROF T1024TL T1024TL 1 HOUR $ 75.00 $ 150.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEI EI INITIAL PSYCH AND DEV EVAL BY EI PROF via Telemedicine T1024TLGT T1024TLGT 1 HOUR $ 75.00 $ 150.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEI EI INITIAL PSYCH AND DEV EVAL BY ITDS T1024HNUK T1024HNUK 1 HOUR $ 55.50 $ 111.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEI EI INITIAL PSYCH AND DEV EVAL BY ITDS via Telemedicine T1024HNUKGT T1024HNUK 1 HOUR $ 55.50 $ 111.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEF OT F/U PSYCH AND DEV EVAL BY OT T1024GOTS T1024GOTS 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF OT F/U PSYCH AND DEV EVAL BY OT via Telemedicine T1024GOTSGT T1024GOTSG 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF PT F/U PSYCH AND DEV EVAL BY PT T1024GPTS T1024GPTS 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF PT F/U PSYCH AND DEV EVAL BY PT via Telemedicine T1024GPTSGT T1024GPTSG 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF Speech F/U PSYCH AND DEV EVAL BY SLP T1024GNTS T1024GNTS 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF Speech F/U PSYCH AND DEV EVAL BY SLP via Telemedicine T1024GNTSGT T1024GNTSG 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI OT INITIAL PSYCH AND DEV EVAL BY OT T1024GOUK T1024GOUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI OT INITIAL PSYCH AND DEV EVAL BY OT via Telemedicine T1024GOUKGT T1024GOUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI PT INITIAL PSYCH AND DEV EVAL BY PT T1024GPUK T1024GPUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI PT INITIAL PSYCH AND DEV EVAL BY PT via Telemedicine T1024GPUKGT T1024GPUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI Speech INITIAL PSYCH AND DEV EVAL BY SLP T1024GNUK T1024GNUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI Speech INITIAL PSYCH AND DEV EVAL BY SLP via Telemedicine T1024GNUKGT T1024GNUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT NESF Travel NATURAL ENVIRONMENT SUPPORT FEE 99600 99600 FLAT RATE $ 10.00 $ 10.00 FLAT RATE CONT OCCT OT OT SESSION BY LICENSED OT 97530 97530 1 HOUR $ 71.96 $ 71.96 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT OCCT OT OT SESSION BY LICENSED OT via Telemedicine 97530GT 97530GT 1 HOUR $ 71.96 $ 71.96 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT OCTF OT OT EVAL BY LICENSED OT, FOLLOW-UP 97168 97168 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTF OT OT EVAL BY LICENSED OT, FOLLOW-UP via Telemedicine 97168GT 97168GT 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (LOW COMPLEXITY) 97165 97165 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (LOW COMPLEXITY) via Telemedicine 97165GT 97165GT 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (MODERATE COMPLEXITY) 97166 97166 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (MODERATE COMPLEXITY) via Telemedicine 97166GT 97166GT 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (HIGH COMPLEXITY) 97167 97167 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (HIGH COMPLEXITY) via Telemedicine 97167GT 97167GT 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT PHY PT PT SESSION BY LICENSED PT 97110 97110 1 HOUR $ 71.96 $ 71.96 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT PHY PT PT SESSION BY LICENSED PT via Telemedicine 97110GT 97110GT 1 HOUR $ 71.96 $ 71.96 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT PSTF PT EVAL BY LICENSED PT, FOLLOW-UP 97164 97164 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT PSTF PT EV
Appears in 2 contracts
Sources: Memorandum of Agreement, Memorandum of Agreement (Moa)
Due Process Hearing. You have the right to file a due process hearing request when there is a disagreement regarding the proposal to initiate or change, or refusal to initiate or change the identification, evaluation, or placement of your child, the provision of appropriate early intervention services to your child or family, or to challenge information in the Early Steps record to ensure that it is not inaccurate, misleading, or otherwise in violation of the privacy or other rights of your child. A due process hearing request must be filed with the Florida Department of Health, Children’s Medical Services, Early Steps State Office at: The party submitting a due process hearing request, or their attorney, must ensure the other party receives a copy of the hearing request, which must remain confidential. A due process hearing request must include the following: • name of your child; • the address of the residence of your child; • the name of the early intervention provider serving your child; • a description of the nature of the problem of your child relating to the proposed or refused initiation or change, including facts relating to the problem; • a proposed resolution of the problem to the extent known and available to you at the time; and • an allegation that the action forming the basis for the due process complaint occurred within 2 years of the date you Early Steps or the provider knew (or should have known) about the alleged action. Within 10 days of a due process hearing request, you will receive a written response from the other party addressing each issue you raised in your due process hearing request. If you have not received prior written notice regarding the issues addressed in your due process hearing request, then the response will also include the following: • an explanation of why Early Steps proposed or refused to take the action raised in the due process hearing request; • a description of other options that the IFSP team considered and the reasons why those options were rejected; • a description of each evaluation procedure, assessment, record, or report used as the basis for the proposed or refused action; and • a description of the other factors relevant to the proposed or refused action. The hearing officer will determine the sufficiency of a due process hearing request. Either party may challenge the sufficiency of the due process hearing request by filing a written claim with the hearing officer within 15 days of the hearing request. Within 5 days of receipt of the challenge, the hearing officer will issue a ruling on the sufficiency of the due process hearing request. Mediation will be offered when a due process hearing request is received and you will be notified of free or low cost legal and other relevant advocacy services that are available. The Early Steps State Office will conduct a resolution meeting within 15 days of the receipt of a due process hearing request with the parent(s) and the relevant IFSP team members, as agreed by both parties. The purpose of the resolution meeting is to allow the Early Steps State Office the opportunity to resolve the issues in the due process hearing request. The Early Steps State Office may not bring an attorney unless you bring an attorney. If you file a due process hearing request and do not participate in the resolution meeting after reasonable efforts by the Early Steps State Office, your due process hearing request may be dismissed. If the Early Steps State Office does not hold or participate in a resolution meeting within 15 days of receipt of the hearing request, you may request the hearing officer to initiate the 45 day due process timeline. The 45 day due process hearing timeline begins after: • both parties agree in writing to waive the resolution meeting or seek mediation; • after the resolution meeting or mediation starts but before the end of the 30 day period and the parties agree in writing that no agreement is possible; or • both parties agree in writing to continue the resolution or meditation process at the end of the 30 day period but later withdraws. If a resolution to the dispute is reached at the resolution meeting, a legally binding agreement is written that is signed by both parties and enforceable in federal or state court. Either party may void the agreement within 3 business days of execution. The Early Steps State Office may use methods to seek enforcement of a written agreement resulting from a mediation or resolution meeting as long as those mechanisms are not mandatory and does not delay or deny the parents right to seek enforcement of the written agreement in a federal or state court. A party may amend a due process hearing request if either the other party consents in writing to the amendment and is given the opportunity to resolve the issues in the due process hearing request through a resolution meeting or the hearing officer grants permission not later than five days before the due process hearing is scheduled. If a party files an amended due process hearing request, the 30 day timeline for the resolution meeting begins again with the filing of the amended due process hearing request. A due process hearing is conducted by an impartial person who is not an employee of Early Steps, or any other entity involved in the services or care for your child, though Early Steps pays for their services. They do not have a personal or professional interest that would conflict with their ability to be objective and implement the process. The hearing officer will have knowledge about Early Steps, including Part C of the Individuals with Disabilities Education Act, applicable federal and state regulations, and legal interpretations by federal and state courts. The officer will listen to relevant viewpoints about the issue, examine all information related to the issues, seek to reach a timely resolution regarding the issue, and make decisions based on substantive grounds. It will be at a time and place that is convenient to you and you will be notified of the date, time, and place of the hearing in a reasonable time in advance. A hearing will be held and a written decision mailed within 45 days of the request of a hearing. The written decision will be based on the evidence and will include a summary of the evidence and the reasons for the decision. During a due process hearing, you have the right to: • be accompanied and advised by counsel and by individuals with special knowledge or training on Early Steps at your own expense; • present evidence and confront, cross examine, and require attendance of witnesses; • not allow evidence that has not been disclosed to you at least five days before the hearing; • receive a written or electronic (based on your preference) word for word copy of the hearing at no cost; • receive a written or electronic (based on your preference) findings and decisions from the hearing at no cost; and • request the hearing be open to the public (it will be closed unless the parties request it be open). Parties involved in the due process hearing must disclose all evaluations and recommendations at least 5 business days before the proceeding. The hearing officer may bar any party that fails to comply without the consent of the other party. The party requesting a due process hearing may not raise issues at the due process hearing that were not raised in the due process complaint unless the other party agrees. In matters alleging a procedural violation, a hearing officer may find that your child was not appropriately identified, evaluated, placed, or provided early intervention services only if it: • Impeded your child’s right to identification, evaluation, and placement or provision of early intervention services for your child and family; • Significantly impeded the your opportunity to participate in the decision-making process regarding identification, evaluation, placement or provision of early intervention services for your child and family; or • Caused a deprivation of developmental benefit. Unless you and Early Steps agree, Early Steps will continue to provide the early intervention services to which you have provided consent or if applying for initial services, will provide the early intervention services not in dispute as authorized on your Individualized Family Support Plan (IFSP). A decision made in a due process hearing is final, except that either party may file a civil action. This must be done in state or federal court within 90 days of the due process decision. In a civil action, the court will receive the records of the due process hearing, hear additional evidence at the request of a party, and grant the relief the court determines to be appropriate, based on the preponderance of the evidence. Parents also have rights, procedures, and remedies available under the Constitution, Americans With Disabilities Act, title V of the Rehabilitation Act, and other federal laws protecting the rights of children with disabilities. EXHIBIT B G – STATEMENT OF UNDERSTANDING OF PART C PROCEDURAL SAFEGUARDS Department of Pediatrics Gainesville, FL 32610 North Central Early Steps PH: ▇▇▇-▇▇▇-▇▇▇▇/▇-▇▇▇ ▇▇▇-▇▇▇▇ FAX: ▇▇▇-▇▇▇-▇▇▇▇ An Equal Opportunity Institution EXHIBIT C – HOMELAND SECURITY STATEMENT Exhibit D ASST AT ASSISTIVE TECHNOLOGY T1999 T1999 EACH ITEM N/A $ 5,000.00 EACH ITEM TPIN and/or MED. If EOB or no coverage, CONT Rate TBD, not auto calculated ASTE AT ASSISTIVE TECHNOLOGY EVAL 97755 97755 1 EVAL $ 48.50 $ 48.50 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT COIFF All IFSP CONSULT, PROF, FACE-TO-FACE n/a COIFF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT COIFF All IFSP CONSULT, PROF, FACE-TO-FACE via Telemedicine n/a COIFFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT COIFP All IFSP CONSULT, PROF, BY PHONE n/a COIFP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT CONIF EI CONSULT FACE-TO-FACE, ITDS n/a CONIF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONIF EI CONSULT FACE-TO-FACE, ITDS via Telemedicine n/a CONIFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONIP EI CONSULT, PHONE, ITDS n/a CONIP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT EIGF EI EI GROUP SESSION BY EI PROF T1027TT T1027TTSC 1 HOUR $ 25.00 $ 25.00 1 HOUR MED if primary or secondary. CONT if only TPIN. EIIF EI EI INDIVIDUAL SESSION BY EI PROF T1027SC T1027SC 1 HOUR $ 50.00 $ 50.00 1 HOUR MED if primary or secondary. CONT if only TPIN. EIIF EI EI INDIVIDUAL SESSION BY EI PROF via Telemedicine T1027SCGT T1027SCGT 1 HOUR $ 50.00 $ 50.00 1 HOUR MED if primary or secondary. CONT if only TPIN. CONOF OT CONSULT FACE-TO-FACE, OT n/a CONOF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONPF PT CONSULT FACE-TO-FACE, PT n/a CONPF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONSF Speech CONSULT FACE-TO-FACE, ST n/a CONSF 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONOF OT CONSULT FACE-TO-FACE, OT via Telemedicine n/a CONOFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONPF PT CONSULT FACE-TO-FACE, PT via Telemedicine n/a CONPFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONSF Speech CONSULT FACE-TO-FACE, ST via Telemedicine n/a CONSFGT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT CONOP OT CONSULT, PHONE, OT n/a CONOP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT CONPP PT CONSULT, PHONE, PT n/a CONPP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT CONSP Speech CONSULT, PHONE, ST n/a CONSP 1 HOUR $ 25.00 $ 25.00 1 HOUR CONT EXIT All EXIT ASSESSMENT n/a EXIT 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT INTR Interpreter INTERPRETER T1013 T1013 1 HOUR $ 50.00 $ 50.00 1 HOUR CONT IPDEF EI F/U PSYCH AND DEV EVAL BY EI PROF T1024TLTS T1024TLTS 1 HOUR $ 75.00 $ 150.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEF EI F/U PSYCH AND DEV EVAL BY EI PROF via Telemedicine T1024TLTSGT T1024TLTSG 1 HOUR $ 75.00 $ 150.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEF EI F/U PSYCH AND DEV EVAL BY ITDS T1024TS T1024TS 1 HOUR $ 55.50 $ 111.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEF EI F/U PSYCH AND DEV EVAL BY ITDS via Telemedicine T1024TSGT T1024TSGT 1 HOUR $ 55.50 $ 111.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEI EI INITIAL PSYCH AND ▇▇▇ EVAL BY EI PROF T1024TL T1024TL 1 HOUR $ 75.00 $ 150.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEI EI INITIAL PSYCH AND DEV EVAL BY EI PROF via Telemedicine T1024TLGT T1024TLGT 1 HOUR $ 75.00 $ 150.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEI EI INITIAL PSYCH AND DEV EVAL BY ITDS T1024HNUK T1024HNUK 1 HOUR $ 55.50 $ 111.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEI EI INITIAL PSYCH AND DEV EVAL BY ITDS via Telemedicine T1024HNUKGT T1024HNUK 1 HOUR $ 55.50 $ 111.00 1 HOUR MED if primary or secondary. CONT if only TPIN. IPDEF OT F/U PSYCH AND DEV EVAL BY OT T1024GOTS T1024GOTS 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF OT F/U PSYCH AND DEV EVAL BY OT via Telemedicine T1024GOTSGT T1024GOTSG 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF PT F/U PSYCH AND DEV EVAL BY PT T1024GPTS T1024GPTS 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF PT F/U PSYCH AND DEV EVAL BY PT via Telemedicine T1024GPTSGT T1024GPTSG 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF Speech F/U PSYCH AND DEV EVAL BY SLP T1024GNTS T1024GNTS 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEF Speech F/U PSYCH AND DEV EVAL BY SLP via Telemedicine T1024GNTSGT T1024GNTSG 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI OT INITIAL PSYCH AND DEV EVAL BY OT T1024GOUK T1024GOUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI OT INITIAL PSYCH AND DEV EVAL BY OT via Telemedicine T1024GOUKGT T1024GOUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI PT INITIAL PSYCH AND DEV EVAL BY PT T1024GPUK T1024GPUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI PT INITIAL PSYCH AND DEV EVAL BY PT via Telemedicine T1024GPUKGT T1024GPUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI Speech INITIAL PSYCH AND DEV EVAL BY SLP T1024GNUK T1024GNUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT IPDEI Speech INITIAL PSYCH AND DEV EVAL BY SLP via Telemedicine T1024GNUKGT T1024GNUK 1 HOUR $ 75.00 $ 150.00 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT NESF Travel NATURAL ENVIRONMENT SUPPORT FEE 99600 99600 FLAT RATE $ 10.00 $ 10.00 FLAT RATE CONT OCCT OT OT SESSION BY LICENSED OT 97530 97530 1 HOUR $ 71.96 $ 71.96 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT OCCT OT OT SESSION BY LICENSED OT via Telemedicine 97530GT 97530GT 1 HOUR $ 71.96 $ 71.96 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT OCTF OT OT EVAL BY LICENSED OT, FOLLOW-UP 97168 97168 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTF OT OT EVAL BY LICENSED OT, FOLLOW-UP via Telemedicine 97168GT 97168GT 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (LOW COMPLEXITY) 97165 97165 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (LOW COMPLEXITY) via Telemedicine 97165GT 97165GT 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (MODERATE COMPLEXITY) 97166 97166 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (MODERATE COMPLEXITY) via Telemedicine 97166GT 97166GT 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (HIGH COMPLEXITY) 97167 97167 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT OCTH OT OT EVAL BY LICENSED OT, INITIAL (HIGH COMPLEXITY) via Telemedicine 97167GT 97167GT 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT PHY PT PT SESSION BY LICENSED PT 97110 97110 1 HOUR $ 71.96 $ 71.96 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT PHY PT PT SESSION BY LICENSED PT via Telemedicine 97110GT 97110GT 1 HOUR $ 71.96 $ 71.96 1 HOUR TPIN and/or MED. If EOB or no coverage, CONT PSTF PT EVAL BY LICENSED PT, FOLLOW-UP 97164 97164 1 EVAL $ 51.41 $ 51.41 EACH EVAL TPIN and/or MED. If EOB or no coverage, CONT PSTF PT EVInstitution
Appears in 1 contract
Sources: Memorandum of Agreement