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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 2 Medicaid Children’s Services Comprehensive Care Program (CCP) : 2.7 Early Childhood Intervention (ECI) Services : 2.7.2 * Services, Benefits, Limitations, and Prior Authorization : 2.7.2.3 Specialized Skills Training (SST)

2.7.2.3
SST is a rehabilitative service that promotes age-appropriate development by providing skills training to correct deficits and teach compensatory skills for deficits that directly result from medical, developmental, or other health-related conditions.
SST services must be provided as stated in 40 TAC, Part 2, Chapter 108, Subchapter E. Documentation of each SST visit must comply with 40 TAC, Part 2, Chapter 108, Subchapter E, §108.501.
SST services must be identified on the IFSP and have been recommended by a licensed practitioner of the healing arts (as defined in 40 TAC, Part 2, Chapter 108, Subchapter A, §108.103).
Be designed to create learning environments and activities that promote the client’s acquisition of skills in one or more of the following developmental areas: physical or motor, communication, adaptive, cognitive, and social or emotional.
Include skills training and anticipatory guidance for family members, or other significant caregivers, to ensure effective treatment and to enhance the client’s development.
Be provided in the client’s natural environment, as defined in 34 CFR Part 303, unless the criteria listed at 34 CFR §303.167 are met and documented in the client’s record.
Recommended by the interdisciplinary team and documented on the IFSP, only when participation in the group will assist the client reach the outcomes in the IFSP.
Documentation of each specialized skilled training contact must include the following:
Providers must submit procedure code T1027 for SST services, which are billed in 15-minute increments. Providers must submit procedure code T1027 when services are performed in a group setting or T1027 with modifier U1 when performed in an individual setting.
SST services are provided by an ECI provider. The ECI provider ensures that SST services are provided by an EIS who meets the criteria established in 40 TAC Part 2, Chapter 108, Subchapter C, §108.313.

Texas Medicaid & Healthcare Partnership
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