Utilizations and Activities

1. UTILIZATION: A Utilization is created to contain all Activities or Services that occurred for a client in one day. Only one Utilization can be created per day. However, there is no limit to the number of Activities that can be logged within the Utilization

2. ACTIVITY: There are three types of Activities within a Utilization: Session Service, Session Other, Session Other Mileage and Transaction

a) Session Service – contains an Activity(ies) related to any Direct Service documented on an IFSP record:

i. EI: Assistive Technology

ii. EI: Assistive Technology Device

iii. EI: Audiology Services

iv. EI: Developmental Intervention

v. EI: Health Services

vi. EI: Medical Services

vii. EI: Nursing Services

viii. EI: Nutrition Services

ix. EI: Occupational Therapy

x. EI: Physical Therapy

xi. EI: Psychological Services

xii. EI: Service Coordination EIST (Note: Not documented on the IFSP)

xiii. EI: Sign Language Cued Speech

xiv. EI: Social/Emotional Intervention

xv. EI: Speech-Language Pathology

xvi. EI: Transportation

b) Session Other - Services that are not entered on the IFSP, may be billed in conjunction with services provided:

i. EI: Teaming – Billed when this is a service delivery method

ii. EI: Co-pay - Billed when private insurance is being used

iii. EI: Interpreter - Billed when interpreter is needed for service provision

iv. EI: Provider Travel - Billed as Time (15- minute units) and Amount (If flat fee or credit)

v. EI: SLP Stipend

Note: Payment of a $30 stipend for subcontracted providers that are billing Medicaid for a speech and/or language session to help support the monitoring of IFSP Outcomes

c) Session Other Mileage

i. EI: Mileage - Billed as Miles and Rate

Note: EI: Mileage is number of miles (distance) a Provider travels in a vehicle, billed as Number of Miles X [up to the Federal Standard Mileage rate) 0.625 per mile. EI: Provider Travel is the amount of time a Provider drives (work time) in a vehicle this is a Rate (Hourly) X Time (15-minute units)

d) Transactions – Activity(ies) conducted within the Client Case not documented on the IFSP record:

i. EI: Assessment-Annual – Billed for Annual IFSP meeting

ii. EI: Assessment-Initial - If billing this code, Eligibility must already have been determined. Used for Initial Family Assessment and IFSP development, including strategies, outcomes, and necessary services to address those outcomes.

Note: A child has an Established Condition is already eligible. EI: Assessment-Initial would be billed as part of the IFSP development to determine the range of delay in each of the five developmental areas

iii. EI: Assessment Reentry - If a child returns to EI after being exited from services for less than three months, or if the child has an established condition, a reentry assessment is completed

Note: IUGR or LBW are only eligible if they are under two years of age.

iv. EI: IFSP Review – Billed any time IFSP is reviewed/updated with family between the Initial and Annual

v. EI: No Show - Billed when services are not provided due to the family cancelling

Note: Reimbursement is one (1) unit per no-show when a family cancels a scheduled visit less than 24 hours before the visit

vi. EI: IFSP No-Show - Billed when IFSP meeting does not take place due to the family cancelling

Note: Reimbursement is two (2) units per no-show when a family cancels a scheduled IFSP meeting less than 24 hours before the visit.