Become a Therapeutic Consultation Provider

Want to help the many individuals who are currently have DD and ID Waivers?  LBAs and LABAs can do this through Therapeutic Consultation.  These individuals are generally adults, but may be children and adolescents as well.

According to the manual (emphasis added): “Therapeutic Consultation provides expertise, training, and technical assistance in any of the following specialty areas to assist family members, caregivers, and other service providers in supporting the individual. The specialty areas are: a. Psychology; b. Social Work; c. Therapeutic Recreation; d. Speech and Language Therapy; e. Occupational Therapy; f. Physical Therapy; g. Rehabilitation Engineering; h. Psychiatry; i. Psychiatric Clinical Nursing. and j. Behavioral Consultation”

The currently allowable activities are:

  1. Interviewing the individual, family members, caregivers, and relevant others to identify issues to be addressed and desired outcomes of consultation;
  2. Observing the individual in daily activities and natural environments;
  3. Assessing the individual’s need for an assistive device or modification and/or adjustment in the environment or services;
  4. Developing data collection mechanisms and collecting baseline data;
  5. Observing and assessing current interventions, support strategies, or assistive devices being used with the individual;
  6. Developing written supporting documentation detailing the interventions, environmental adaptations, and support strategies to address the identified issues and desired outcomes; this may include recommendations related to specific devices, technology, or adaptation of other training programs or activities;
  7. Demonstrating specialized, therapeutic interventions, individualized supports, or assistive devices;
  8. Training family/caregiver and other relevant persons to assist the individual in using an assistive device, to implement specialized, therapeutic interventions, or adjust currently utilized support techniques;
  9. Training relevant persons to better support the individual simply by observing the individual’s environment, daily routines, and personal interactions;
  10. Reviewing documentation and evaluating the efficacy of assistive devices or the activities and interventions identified in the supporting documentation; and
  11. Training and technical assistance to family members, caregivers, and other individuals primarily responsible for carrying out the individual’s POC.

How do you become a Therapeutic Consultation provider with DBHDS?

  1. First, create a login at https://www.virginiamedicaid.dmas.virginia.gov/wps/portal/WebRegistration.
  2. Click on the Provider Enrollment tab (upper right) and begin an application. Choose Developmental Disability Waiver.  Note the phone number at the top of the screen (888-829-5373) and contact them if you have any specific questions.  You may also email VABA at admin@virginiaaba.org with any questions.
  3. The questions should be self-explanatory. You will need to enter your NPI number.  If you do not have one, you can apply for one using your license here: https://nppes.cms.hhs.gov/NPPES/Welcome.do
  4. Make sure that your name matches your NPI. If you are using an individual NPI number, you should use an individual name and social security number, not a company name and TIN.
  5. When asked about the service you wish to provide, choose “Therapeutic Consultation.”  If you already provide other waiver services, check those services as well – even though you were previously approved, because the system will reset.

Congratulations!  It’s that easy!  But it may take a month or so to become approved.

Once approved, work with your local CSB to get cases.  You will need to use WAMS for authorizations and to add in your service plan.  WAMS is not a very intuitive system, although there is a user guide.  To set up a login, call the Support Line: 844-4-VA-WaMS (844-482-9267).

DBHDS has issued a guidance document on writing goals for ISPs for those with the DD waiver.  This applies to Therapeutic Consultation and any other DBHDS licensed service for waiver recipients.

To learn more about the service, read the manual by going to “Provider Resources” and choosing the “Individual and Family Developmental Disabilities Waiver Services” manual.  For specific information on Therapeutic Consultation, see Chapter IV Covered Services and Limitations.  But there is important info in the rest of the manual as well, especially with regard to billing.

The code for this service is 97139 and is billed per hour at the following rates: those in Northern Virginia – $92.85/hour; those in the rest of the state – $87.75/hour.  To bill you use the same Medicaid portal where you registered and click on the Claims heading.

For a good Web site that has general information on the DD waiver, go to http://www.mylifemycommunityvirginia.org/.

For information on the autism and behavioral competencies, click here.

Finally for more information, log into our member page and see the Webinar on this subject (from Sept 2018)

Subscribe to VABA News!

Sign up to receive an email each time we update the news.







0