A snapshot of Georgia: Children's Intervention Services, a program of the Georgia Department of Community Health [Jan. 2009]

A Program Of The Georgia Department Of Community Health
A SNAPSHOT OF GEORGIA
Children's Intervention Services

Overview
The Children's Intervention Service (CIS) program offers coverage for restorative and rehabilitative services to eligible members in noninstitutional settings, including their home, therapist's office, child care or other community setting. CIS services must be determined to be medically necessary, and be recommended and documented as appropriate intervention by a physician.
Why is the program important?

SERVICES
Audiology Nursing Nutrition provided by licensed dietitians Occupational therapy Physical therapy Counseling provided by licensed clinical social workers Speech-language pathology

The intent of the program is for the maximum reduction of the effects of a physical disability or developmental delay.
Has the Children's Intervention Services program changed?
DCH strives to ensure the right care is provided to the right children at the right time. A child's need for therapy can change over time, and by standardizing the Prior Authorization (PA) review process and assuring medical necessity, DCH can be more certain that the program meets each individual child's medical needs. Beginning September 1, 2006, a PA was required for units over eight per member per month for therapy in the same specialty. These units include the evaluation visit. A PA is based on medical necessity and can be approved for up to six months.

ELIGIBILITY
Medicaid-eligible members from birth up to the age of 21-years old with physical disabilities or with a developmental delay, who have been recommended for rehabilitative or restorative intervention services by a physician.

What has the Georgia Department of Community Health (DCH) done to enhance Children's Intervention Services systems?

DCH allows providers to attach electronic documentation directly to pending PAs. This enhancement gives the provider greater control in assuring that all documentation is associated with the review for Medical Necessity. Immediate verification goes back to the provider that the documentation was successfully uploaded
DCH also established dedicated fax lines for provider use (800-969-6358 or 678-527-3031) DCH developed a family of general codes which allows the provider more flexibility in their provision of
CIS services DCH no longer requires the submission of a separate prescription and allows the physician's signature
on the Letter of Medical Necessity/Written Service Plan to serve as his prescription for services DCH allows hospital based providers to enroll in the CIS program with the ability to see members at
their local medical facility

2 Peachtree Street, Atlanta, Ga 30303 www.dch.georgia.gov

January 2009