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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 29. PUBLIC WELFARE |
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Chapter 29-71. MEDICAID REIMBURSEMENT FOR EARLY INTERVENTION SERVICES |
Section 29-7114. MEDICAID REIMBURSEMENT RATES
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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)
$37.50/15 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
V2799 R2 (individual RC2)
$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 PT assistants, OT assistants, certified therapeutic recreational specialists, counselors, special educators, dietitians, family therapists, orientation and mobility specialists, social workers certified nurse aides, LPNs, ABA paraprofessionals, and board certified assistant behavior analysts (BCaBAs).
**Per professional.