developing and monitoring appropriate plans to address the nutritional needs of eligible children and making referrals to appropriate community resources to achieve the nutrition goals in the IEP/IFSP. See the on page 26 of this manual for specific nutrition procedure codes. OCCUPATIONAL THERAPY SERVICES Occupational therapy services include any screenings, evaluations or treatments delivered by a licensed occupational therapist, or treatments delivered by licensed occupational therapy assistant, which are necessary to develop and implement an IEP/IFSP. See the on pages 25-26 of this manual for specific occupational therapy procedure codes. PHYSICAL THERAPY SERVICES Physical therapy services include evaluations or treatments delivered by a licensed physical therapist, or treatments delivered by a physical therapy assistant, which are necessary to develop and implement an IEP/IFSP. See the on page 25 for specific physical therapy codes. SPEECH LANGUAGE PATHOLOGY SERVICES Speech language pathology services include evaluations, diagnosis, or treatments delivered by a licensed speech language pathologist, or treatments delivered by a licensed speech language pathology assistant, which are necessary to develop and implement an IEP/IFSP. A speech language pathologist with a limited license who is completing his/her Clinical Fellowship can bill for both evaluations and treatment. A supervision log is not required for the purpose of the IMMT review. See the on page 24 of this manual for specific speech language pathology codes. THERAPEUTIC BEHAVIOR SERVICES Therapeutic behavior services are one-to-one rehabilitative services, necessary to develop and implement IEP/IFSP and delivered by a therapeutic behavior aide, using appropriate methods of preventing or decreasing maladaptive behaviors for a Medicaid participant. The therapeutic behavior aide must be supervised by a licensed physician or licensed mental health professional. See the on page 25 of this manual for the therapeutic behavior services code. TRANSPORTATION SERVICES Specialized transportation services are transportation services provided pursuant to COMAR 10.09.25. The limit for Transportation Services is two (2) units per day.
IEP/IFSP HEALTH RELATED SERVICE PROCEDURE CODES & FEE SCHEDULE EFFECTIVE 06/01/2016 As a Maryland Medicaid provider, it is your responsibility to bill the Program appropriately for all school health related and early intervention health related services including service coordination and transportation services. Procedure Code Procedure Description Qualified Provider Unit of Service Rate per Unit Maximum Units of Service 90791 Psychiatric Diagnostic Interview Modifier AF Licensed Psychiatrist 1 $151.68 AH Licensed Psychologist 1 $123.50 AJ Licensed CSW-C 1 $108.13 AJ LCPC 1 $108.13 AJ Licensed Nurse Psychotherapist 1 $108.13 90832 Individual psychotherapy Licensed Psychiatrist, Licensed Psychologist, Licensed Certified Social Worker-Clinical, Licensed Professional Counselor, Licensed Nurse Psychotherapist 20-30 min $40.89 one per day; cannot bill 90834 on the same day 90834 Individual psychotherapy Licensed Psychiatrist, Licensed Psychologist, Licensed Certified Social Worker-Clinical, Licensed Professional Counselor, Licensed Nurse Psychotherapist 45-50 min $74.10 one per day; cannot bill 90832 on the same day 90847 Family psychotherapy Licensed Psychiatrist, Licensed Psychologist, Licensed Certified Social Worker-Clinical, Licensed Professional Counselor, Licensed Nurse Psychotherapist 1 $77.94
90853 Group psychotherapy Licensed Psychiatrist, Licensed Psychologist, Licensed Certified Social Worker-Clinical, Licensed Professional Counselor, Licensed Nurse Psychotherapist 1 $25.25 92521 Evaluation of speech fluency Licensed Speech Pathologist 1 $91.35 maximum units: one time per 12 months; cannot bill 92507 or 92508 on the same day 92522 Evaluation of speech sound production Licensed Speech Pathologist 1 $74.00 maximum units: one time per 12 months; cannot bill 920507, 92508 or 92523 on the same day 92523 Evaluation of speech sound production with evaluation of language comprehension & expression Licensed Speech Pathologist 1 $153.97 maximum units: one time per 12 months; cannot bill 92507, 92508 or 92522 on the same day 92523 with 52 Modifier Evaluation of language comprehension & expression Licensed Speech Pathologist 1 $79.97 maximum units: one time per 12 months; cannot bill 92507, 92508 or 92522 on the same day 92524 Behavioral & qualitative analysis of voice & resonance Licensed Speech Pathologist or Licensed Speech Pathology Assistant 1 $77.40 maximum units: one time per 12 months; cannot bill 92507, 92508 or 92522 on the same day 92507 Individual speech therapy Licensed Speech Pathologist or Licensed Speech Pathology Assistant 1 $63.99 one time per day; cannot bill 92508 on the same day 92508 Group speech therapy Licensed Speech Pathologist or Licensed Speech Pathology Assistant 1 $30.47 one time per day; cannot bill 92507 on the same day