TMPPM 2011 > Children's Services Handbook > Medicaid Children's Services Comprehensive Care Program (CCP) > Early Childhood Intervention (ECI) (CCP)

   
 

2. Medicaid Children's Services Comprehensive Care Program (CCP)

2.1 Early Childhood Intervention (ECI) (CCP)

The Texas ECI program is available statewide to families of children who are birth through 35 months of age and who have disabilities or developmental delays. The state agency responsible for ECI services is the Department of Assistive and Rehabilitative Services (DARS). DARS contracts with local ECI programs to take referrals, determine clients' eligibility for ECI, and provide services to ECI-eligible children.

To participate in Texas Medicaid, ECI providers must comply with all applicable federal, state, and local laws and regulations pertaining to ECI services. The ECI providers must provide services in accordance with IDEA, Part C and Title 40 TAC, Part 2, Chapter 101, Subchapter 1 and Title 40 TAC, Part 2, Chapter 108.

ECI providers enroll as CCP providers. ECI CCP providers who complete occupational therapy (OT), physical therapy (PT), or speech therapy (ST) evaluations and re-evaluations for children in the non-managed care areas of the state must submit their claims to TMHP. ECI CCP providers who complete OT, PT, or ST evaluations and re-evaluations for children enrolled in Medicaid Managed Care plans must submit their claims to the appropriate Health Maintenance Organization (HMO).

For the children who qualify for Developmental Rehabilitation Services (DRS), the ongoing OT, PT, or ST services and developmental services are considered bundled services that are billed outside of the TMHP claims payment system. These ongoing therapy and developmental services, as stated on the child's IFSP, are reimbursed through the ECI provider's contract with DARS. ECI DRS are reimbursed in accordance with 1 TAC 355.113.

Nutrition, audiology, counseling, and psychological services provided to eligible children by ECI CCP providers are reimbursed through TMHP for children in the non-managed care areas of the state or the appropriate HMO if the child is enrolled in a Medicaid Managed Care health plan.

Other ECI services, as defined in Title 40 Texas Administrative Code (TAC), Part 2, Chapter 108, Subchapter E, 108.3 include case management services, vision services, social work, family education and training, assistive technology, behavioral intervention, and health services.

Refer to: Section 4, "Early Childhood Intervention (ECI) Targeted Case Management Services" in the Behavioral Health, Rehabilitation, and Case Management Services Handbook (Vol. 2, Provider Handbooks).

ECI Referrals and Assistance to ECI Enrolled Children

Medicaid professionals can assist families enrolled in ECI by:

Making referrals to the ECI program (refer to Appendix D.4 Early Childhood Intervention (ECI) Referrals).

Promptly scheduling appointments for well-child exams.,

Providing documentation of the well-child exam and medical information to the ECI program upon request.

Providing prescriptions, when necessary.

For more information on ECI services, providers may visit the ECI website at www.dars.state.tx.us/ecis/index.shtml.

Refer to: Subsection 2.10, "Therapy Services (CCP)" in this handbook for more information.

Subsection 2.6, "Medical Nutrition Counseling Services (CCP)" in this handbook for more information.


Texas Medicaid & Healthcare Partnership
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