Section 17b-262-603 - Payment(a) The department shall establish payment rates effective July 1, 1996.(b) The rate period shall be the state fiscal year.(c) Interim rates shall be issued for each rate period and such rates shall be replaced by rates computed on the basis of actual cost and service volume submitted to the department by the billing provider by December 31 each year for the immediately preceding state fiscal year.(d) Payment shall not be made directly to AHPs or organizations under contract to a performing provider or a billing provider.(e) Payment limitations shall be as follows:(1) payment for evaluations; early intervention services, which includes assessments; and assistive technology devices shall not duplicate payments made under the Medical Assistance Program for other services which are covered under the Program;(2) any Medical Assistance Program Birth to Three eligible child is qualified to be evaluated for eligibility for Part H of IDEA;(3) payment shall be made for early intervention services only for the period covered by the written authorized IFSP;(4) once a child is determined ineligible for Part H of IDEA, payment shall not be made for assessment and early intervention services;(5) claims for payment shall be submitted to the department only by the billing provider or its designated agent;(6) payment for early intervention services, excluding evaluations, shall not be made unless one or more of the individual services pursuant to section 17b-262-601 are rendered in a calendar month;(7) payment shall be made for evaluations regardless of whether the child becomes eligible for the Birth to Three System;(8) evaluations shall be based on a cost per evaluation basis;(9) other early intervention services, including assessments, shall be no more than two units per child per calendar month;(10) rates for early intervention services shall include assistive technology devices having a cost equal to or less than two hundred and fifty dollars; and(11) rates for assistive technology devices having a cost of more than two hundred and fifty dollars, shall be based on the applicable Medical Assistance Program durable medical equipment fee schedule.Conn. Agencies Regs. § 17b-262-603
Effective August 28, 1998