EIDBI updates, new billing information

• 01/29/2026

Updates to Early Intensive Developmental and Behavioral Intervention (EIDBI) services

1. Per Hennepin Health’s contract, EIDBI providers must provide clinical supervision for a minimum of one (1) hour for every sixteen (16) hours of direct treatment per person, unless otherwise authorized in the Enrollee's individual treatment plan. EIDBI providers must provide required EIDBI intervention observation and direction at least once per month. 
2. A recent Minnesota Department of Human Services (DHS) email notification outlined the following updates to the Minnesota Health Care Programs (MHCP) provider manual for EIDBI: 
   
   • “EIDBI billing grid (PDF, 1MB):  
     
     • We updated the billing grid language for CPT codes 97151 and T1024 to clarify eligible provider types. 
       
     • We updated to clarify 0373T is billed once per session based on the face-to-face time of a single provider, even when multiple providers are present, and must be delivered under the direction of a Level I or Qualified Supervising Professional provider on site. 
       
     • We explained midpoint billing rules require that units may only be billed if at least half of the unit time is provided. Daily limits indicate the maximum allowed to bill, but all services must be medically necessary. 
       
     • We updated 97155 to state the authorized amount should be about 20% of total intervention time (97153, 97154, 0373T), unless the Individual Treatment Plan specifies otherwise.” 
3. Hennepin Health has NCCI edits in place to look for duplicate billing. For billing multiple services for one patient, use appropriate modifiers based on subsequent service provided each day by the same or different practitioner. Effective Feb. 1, bill appropriate modifiers to avoid duplicate claim line denials.

• Modifier 76: Repeat procedure (same practitioner, same day)
• Modifier 77: Repeat procedure by another practitioner (different practitioner, same day) 
• Modifier 59: Use appropriately when the procedures are performed in different encounters on the same day

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