D.C. Mun. Regs. tit. 5, r. 5-A3113
The Lead Agency shall establish and publish on an annual basis, or more frequently if necessary, maximum rates to be paid for early intervention services consistent with this chapter.
The following schedule shall be used to determine rate of payment for services in the Early Intervention Service System.
Services | Procedure Codes | Rate |
Assistive Technology Services | DME Procedure Codes | Varies depending on code |
Assessments for Service Planning | T1023 R1 (RC1) T1023 R2 (RC2) | $37.50/15 min $28.50/ 15 min |
Audiology | G0153 GP (group) | $25.13/15 min |
G0153 R1 (individual RC1) G0153 R2 (individual RC2) | $37.50/15 min $28.50/15 min | |
Developmental Therapy | T1027 R2 (individual RC2) | $27.50/15 min |
Developmental Therapy - Applied Behavioral Analysis Method | T1027 R1 (individual RC1) T1027 R2 (individual RC2) T1027 GP (group) | $31.25/15 min $27.50/15 min $18.43/15 min |
Group Therapy (two (2) or more children) | T1027 GP (group) | $18.43/15 min |
Nursing Services | G0154 U1 (individual) | $37.50/15 min |
G0154 GP (group) | $25.13/15 min | |
Nutrition Services | 97802 R2 (initial) | $30.41/15 min |
97803 R2 (subsequent) | $26.49/15 min | |
97804 R2 (group) | $13.32/15 min | |
Occupational Therapy | G0152 U1 (individual) | $37.50/15 min |
G0152 GP (group) | $25.13/15 min | |
Social Work Services | 90806 | $70.94/50 min |
90846 | $71.06/50 min | |
Psychological Services | 90802 | $146.76/dx interview |
90804 | $54.06/30 min | |
90806 | $70.94/50 min | |
90808 | $103.32/80 min | |
90810 | $55.23/30 min | |
96111 | $108.22 | |
Physical Therapy | G0151 U1 (individual RC1) G0151 U1 (individual RC2) | $37.50/15 min $28.50/15 min |
G0151 GP (group) | $25.13/15 min | |
Speech-Language Pathology | G0153 U1 (individual RC1) G0153 U1 (individual RC2) | $37.50/15 min $28.50/15 min |
G0153 GP (group) | $25.13/15 min | |
Team Treatment Activities (more than one professional providing services during same session for an individual child/family) | T1024 R1 (individual RC1) | $37.50/15 min |
Vision Services/Orientation & Mobility | V2799 R2 (individual R2) | $37.50/15 min |
*Reimbursement Category 1 (RC 1) providers are physical therapists, occupational therapists, speech-language pathologists, nurses (registered nurses or nurse practitioners), psychologists, board certified behavior analysts (BCBAs), audiologists, certified assistive technology specialists, and certified auditory verbal therapists or educators. |
*Reimbursement Category 2 (RC 2) providers are physical therapy assistants, occupational therapy assistants, speech language pathology assistants, certified therapeutic recreational specialists, counselors, special educators, dietitians, family therapists, orientation and mobility specialists, social workers certified nurse aides, licensed practical nurses, ABA paraprofessionals, and board certified assistant behavior analysts (BCaBAs). **Per professional. |
The Lead Agency may, in its sole discretion, adjust a rate specified in this chapter, based upon identification and documentation of unique or highly specialized need of a child that cannot be addressed and funded at the rates annually established by the Lead Agency.
D.C. Mun. Regs. tit. 5, r. 5-A3113