Comprehensive Diagnostic Evaluations (CDE)
Comprehensive Diagnostic Evaluations
Comprehensive Diagnostic Evaluation Requirements stipulated by Medicaid began in 2019
Medicaid defines this new required evaluation as a thorough review and assessment of the child’s development and behavior using national, evidence-based practice standards. This evaluation is a requirement by Medicaid for parents seeking Applied Behavior Analysis (ABA) or Behavior Analysis (BA) services for their children. BA services can be provided to children facing maladaptive behaviors and who are at risk for injuring themselves and others. Diagnosis also plays a big role in these children/adolescents being approved for this therapy, for example, a child must have a disorder of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactive Disorder (ADHD), Oppositional Defiant Disorder (ODD), or other similar behavior problems.
Medicaid required this evaluation to receive BA services in the following cases:
Medicaid defines this new required evaluation as a thorough review and assessment of the child’s development and behavior using national, evidence-based practice standards. This evaluation is a requirement by Medicaid for parents seeking Applied Behavior Analysis (ABA) or Behavior Analysis (BA) services for their children. BA services can be provided to children facing maladaptive behaviors and who are at risk for injuring themselves and others. Diagnosis also plays a big role in these children/adolescents being approved for this therapy, for example, a child must have a disorder of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactive Disorder (ADHD), Oppositional Defiant Disorder (ODD), or other similar behavior problems.
Medicaid required this evaluation to receive BA services in the following cases:
- In order to initiate (for the first time) behavior analysis services, the Agency requires that the provider submit a copy of the child’s Comprehensive Diagnostic Evaluation (CDE), along with all other required documentation to eQHealth Solutions, Inc. The CDE will only be required to be submitted one-time and the child will not have to obtain another CDE to continue services.
- If a CDE has never been submitted with a previous authorization request. In these circumstances, the child does not have to get a new CDE if one was completed in their lifetime. The provider can submit the last CDE completed. If a CDE was never completed, eQHealth will extend the authorization to allow time for the child to obtain a CDE.