Conn. Agencies Regs. § 17b-262-601

Current through December 27, 2024

Section 17b-262-601 - Services covered and limitations

(a) The department shall pay for the following:

(1) evaluations and assessments;

(2) early intervention services, which are medically appropriate and medically necessary as follows:

(A) assistive technology devices and assistive technology services;

(B) audiology;

(C) family training, counseling, and home visits;

(D) health services;

(E) medical services;

(F) nursing services;

(G) nutrition services;

(H) occupational therapy;

(I) physical therapy;

(J) psychological services;

(H) service coordination;

(I) social work services;

(J) special instruction;

(K) speech-language pathology;

(L) transportation and related costs; and

(M) vision services; and

(3) services provided in the child's natural environment to the maximum extent appropriate to the needs of the child.

(b) Limitations on covered services shall be as follows:

(1) DMR, or another state agency, shall be the agencies eligible for enrollment with the department to bill for early intervention services to Birth to Three eligible children and their families and to enter into a billing provider agreement with the department for the provision of such services;

(2) services shall be limited to those early intervention services authorized, by a parent or other person empowered to consent on behalf of an eligible child, in the IFSP;

(3) effective July 1, 1996, service coordination shall become part of the early intervention services fee;

(4) special instruction, developmental therapy, requires a signature by a licensed practitioner of the healing arts documenting the existence of a multidisciplinary team, and stating that he or she has periodically reviewed the child's progress and has recommended appropriate techniques, activities, and strategies during discussions with the child's early intervention teacher. Documentation of this requirement in a format and manner to be described by the department shall be signed and dated quarterly;

(5) treatment services are limited to a maximum of one per day of the same type of treatment service per child;

(6) evaluation services are limited to a maximum of one per month, per child;

(7) services are limited to those listed in the department's fee schedule;

(8) services of an unproven, educational, social, experimental, research, or cosmetic nature are not covered;

(9) immunizations, biological products, and other products or examinations and laboratory tests for preventable diseases available free of charge are not covered;

(10) speech services involving nondiagnostic, nontherapeutic, routine, repetitive, and reinforced procedures or services for the child's general welfare that are not planned and performed or supervised by a licensed speech pathologist are not covered;

(11) payment for services by an AHP whose scope of practice is defined under state law when the service that was provided is not within said scope of practice; and

(12) payment for services by an AHP whose scope of practice is not defined under state law when the service that was provided is not within the accepted standard in his or her respective profession or the AHP is otherwise prohibited under state law from providing said service.

Conn. Agencies Regs. § 17b-262-601

Effective August 28, 1998