Section 5-A2853. RATE SETTING - EVALUATIONS

 

2853.1 The Maximum Evaluation Cost to be paid for each of the following evaluations will be calculated by multiplying the corresponding individual related service rate as described in section 2852 by the maximum number of hours permitted to be billed for each evaluation, as provided in the following chart:

Evaluation	Relevant DHCF Procedure Code Description(s)	Maximum Number of Hours	Corresponding Related Service Rate
(a) Audiology Evaluation	Evaluation of speech, language, voice, communication, and/or aural rehabilitation status	4	Audiology, 2852.1(a)
(b) Comprehensive Psychological Evaluation	Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, for example, MMPI, Rorschach, WAIS), per hour of the psychologist’s or physician’s time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report	13	Counseling by a Psychologist, 2852.1(b)(3)
(c) Neuropsychological Testing Battery	Neuropsychological testing battery (for example, Halstead-Reitan, Luria, WAIS-R) with interpretation and report	10	Counseling by a Psychologist, 2852.1(b)(3)
(d) Neuropsychological Evaluation	See the descriptions for the Comprehensive Psychological Evaluation and Neuropsychological Testing Battery	See the maximum hours for (b) + (c) above.	Counseling by a Psychologist, 2852.1(b)(3)
(e) Occupational Therapy Evaluation	Occupational therapy evaluation or re-evaluations	6	Occupational Therapy, 2852.1(c)
(f) Psychiatric Evaluation	Psychiatric diagnostic interview examination	10	Counseling by a Psychiatrist, 2852.1(b)(4)
(g) Physical Therapy Evaluation	Physical therapy evaluation or re-evaluation	4	Physical Therapy, 2852.1(d)
(h) Speech-Language Evaluation	Evaluation of speech, language, voice, communication, auditory processing, and/or aural rehabilitation status	8	Speech-Language Pathology, 2852.1(e)

 

2853.2A nonpublic special education school, program, evaluator, or related service provider shall obtain from OSSE prior written approval for an evaluation rate that is not provided for in this section.  OSSE shall not pay for such a related service unless the rate is specifically approved by OSSE as part of the most recent certificate of approval process or through a separate rate review process.  

 

(a) Unless otherwise set by the District’s Medicaid Program for PRTFs, the 

Maximum Evaluation Cost for an evaluation provided to a student enrolled in a nonpublic special education day or residential school or program shall be aligned to the United States Department of Labor Bureau of Labor Statistics (BLS) Metropolitan Area Occupational Employment and Wage Estimates for the geographic area in which the day or residential program is located and multiplied by the permitted number of hours.

 

authority

The State Superintendent of Education, pursuant to the authority set forth in sections 3(b)(8) and (11) of the State Education Office Establishment Act of 2000, effective October 21, 2000 (D.C. Law 13-176; D.C. Official Code § 38-2602(b)(8) and (11)) (Supp. 2010.); sections 101 et seq. of the Placement of Students with Disabilities in Nonpublic Schools Amendment Act of 2006, effective March 14, 2007 (D.C. Law 16-269; D.C. Official Code §§ 38-2561.01, et seq.) (Supp. 2010); Mayor’s Order 2007-149 (June 28, 2007); and Article II of An Act to provide for compulsory school attendance, and for other purposes, approved February 4, 1925 (43 Stat. 805; D.C. Official Code §§ 38-202 et seq.) (2001 & Supp. 2010).

source

Notice of Final Rulemaking published at 58 DCR 5442, 5457 (July 1, 2011).