Fact sheet: Children's Intervention Services [Nov. 2013]

Fact Sheet

Children's Intervention Services

Overview
The Children's Intervention Services (CIS) Program offers coverage for restorative and rehabilitative services to eligible members in non-institutional settings, including their home, therapist's office, child care or other approved community setting. CIS must be determined to be medically necessary, recommended and documented as appropriate interventions by a physician. NOTE: Hospital-employed therapists who are enrolled in the CIS program may provide services and bill for services rendered in the hospital outpatient facility or outpatient clinic.
Why Is the Program Important?
The intent of the program is to minimize the effects of a physical disability or developmental delay and improve the functional level of the child.
Why Does the Program Require Prior Authorizations?
The Georgia Department of Community Health (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 confident that the program meets each child's medical needs.
What Has 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 to confirm that the documentation was successfully uploaded.

Services Audiology Nursing Nutrition provided by licensed dietitians Occupational therapy Physical therapy Counseling provided by licensed clinical social workers Speech-language pathology
Eligibility Medicaid-eligible members from birth up to the age of 21 with physical disabilities or with a developmental delay, who have demonstrated medical necessity for rehabilitative or restorative intervention services ordered by a physician.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

November 2013

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AM-10-1-13

Fact Sheet
An Overview of Children's Intervention Services
DCH has developed a family of general codes that allows providers more flexibility in their provision of CIS Program services. DCH no longer requires the submission of a separate prescription and allows the physician's signature on the signed and dated Letter of Medical Necessity/Written Service Plan/Plan of Care to serve as the 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.
For More Information
Visit www.dch.georgia.gov for additional information.


Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

November 2013

2 of 2

AM-10-1-13