Fee Schedule

1 Fee Schedule Updated April 2, 2018. Table of Contents Table of i Introduction .. 1. Vendor and Provider Requirements .. 1. DVR Vendor Code of Ethics .. 1. Objectivity .. 1. Nondiscrimination .. 1. Sound Business Practices .. 2. Integrity and 2. Usual and Customary Guidance .. 2. Established Catalog Prices or Market Prices .. 2. Historical Prices or Rates for Similar Goods/Services .. 2. Cost/Price Analysis .. 3. References of Usual and Customary .. 3. Overview of Vocational Services and Goods .. 5. CPT codes .. 5. Monthly Payment Rates .. 5. Hourly Payment Rates .. 5. Rate Adjustments for Service Settings .. 5. State Ownership of Equipment, Tools, and Other Non-Prescription Goods .. 6. Worker's Compensation .. 6. Fiscal Procedures for Service 6. 6. Invoice 7. Cancellation Fees for Services .. 7. Provider Travel Time .. 7. Community-Based Site Setup.

2 8. Payment to Employers for Use of Their Work Site/Location .. 8. Provider Agreement .. 8. Chapter 1: Medical and Psychological Goods and Services .. 9. Least Possible 9. Establishment of Allowable Fees: Relative Values for Physicians (RVP) .. 9. RVP Conversion Factors for Medical Treatment Procedures ..10. Fee Adjustment for Unusual Circumstances ..10. Fee Adjustments for Type of DVR Fee Schedule | April 2, 2018 Page i Diagnostic and Evaluation Services ..12. Medical Diagnostic and Evaluation Services (General Medical Exams, Consultation, Occupational Therapy, Physical Therapy, Specialist Evaluations) ..12. Laboratory and X-Ray Services ..13. Hearing Assessments ..14. Psychological (Psychiatric, Neurofunctional, and Psychological) Diagnostic and Evaluation Services ..14. Medical Restoration Services ..14. Treatment Plan ..14. Surgical Procedures.

3 15. Laboratory and X-Ray Services ..16. Physical Medicine Restoration Services ..16. Massage Therapy Services ..16. Acupuncture Services ..17. Home Health Services ..17. Psychological (Including Psychiatric and Neurofunctional) Restoration Services ..17. Treatment Plan ..17. Duration of Services ..18. Use of Independent Use of Mental Health Centers ..18. Rates According to Conversion Factor and Allowable CPT codes for Psychological Evaluation and Psychotherapy ..18. Substance Abuse Evaluation and Counseling ..19. Other Fees ..20. Cancellation Fee ..20. Provider Travel Time ..20. Reports from File Fee ..20. Out-of-State Medical Treatment ..21. Invoices ..21. Chapter 2: Medical Treatment Facility Services ..23. Requirements ..23. Medical Treatment Facility Rates ..23. In-State Inpatient DVR Fee Schedule | April 2, 2018 Page ii In-State Outpatient Services.

4 24. Out-of-State Medical Facility Services ..26. Invoicing ..26. Chapter 3: Medical Supplies and Equipment ..27. Medical Supplies ..27. Durable Medical Equipment ..27. Rental and Repair of Durable Medical Equipment ..27. Chapter 4: Drugs and Medications ..28. Requirements ..28. Comparable Rates of Payment ..28. Oral Medication ..28. Injections ..28. Controlled Substances ..28. Chapter 5: Prosthetic and Orthotic Services ..29. Requirements ..29. Visual Prosthetic Devices ..29. Corrective Eyeglasses ..29. Ocular Prostheses and Intraocular Lenses ..30. Other Prosthetic Devices ..31. Orthotic Devices ..31. Chapter 6: Dental Restoration Services ..32. Requirements ..32. Diagnostic Dental Services ..32. Dental Consultation ..32. Dental Treatment Services ..32. Orthodontic Treatment Services ..32. Dental X-Rays or Lab Required for Restoration.

5 33. Chapter 7: Non-Medical Assessment Vocational Evaluation ..34. Standardized Vocational Evaluation ..34. Situational Assessment (SA) ..34. Payment to Employers for Use of a Work Site/Location ..36. Community-Based Site Set Up ..36. DVR Fee Schedule | April 2, 2018 Page iii Personal Adjustment Evaluation ..36. Personal Adjustment Evaluation for Persons with Disabilities Other Than Visual Impairments, Facility-Based ..37. Personal Adjustment Evaluation for Persons with Disabilities Other Than Visual Impairments, Community-Based ..37. Personal Adjustment Evaluation for Persons with Visual Impairments, Facility-Based ..37. Personal Adjustment Evaluation for Persons with Visual Impairments, Community- Based ..38. Orientation & Mobility Evaluation ..38. Rehabilitation/Assistive Technology Evaluation ..38. Adaptive/Specialized Driving Evaluation.

6 39. Occupational Testing and Exams ..39. Requests for Background Checks, Transcripts, and Vocational Reports ..39. Background Checks ..39. Transcripts ..39. Copies of Vocational Reports ..39. Chapter 8: Training Services ..40. Community-Based Site Set-Up Payment to Employer for Use of a Work Site/Location ..40. Assistive Adjustment Training ..40. Work Adjustment Training (WAT) ..40. Personal Adjustment Training (PAT) ..41. Orientation & Mobility Training ..43. Communication Skills Training ..44. Cognitive/Learning Disabilities Training ..44. On-the-Job Training (OJT) ..44. Requirements ..44. Registered Apprenticeship Training ..45. Requirements ..45. Paid Work Experience (PWE)..45. Requirements ..45. Purchasing Procedures ..46. Payment DVR Fee Schedule | April 2, 2018 Page iv BEP Training ..46. BEP Skills Training & Materials ..46. BEP Specialty Training & Consultation.

7 47. BEP Payment to Operator for Use of Location ..47. Educational and Training Institutions ..47. Duration of Training ..47. Tutorial Services ..48. Vocational, Trade, and Business School ..48. College or University ..48. High School Equivalency Exam (GED, HiSET, TASC) ..49. Books, Supplies, & Other Training Non-Adaptive Training Equipment ..50. Other Skill Training ..50. Driver's Training ..50. Adaptive or Specialized Driver's Training ..50. Chapter 9: Communication Services ..51. Certified Interpreter, Certified Deaf Interpreter, Communication Assistant, and Deaf Communication Assistant Services ..51. Qualified Communication Assistants ..51. Certified Interpreter, including Certified Deaf Interpreter ..52. Communication Assistant, including Deaf Communication Assistant ..52. Communication Services Provided by a Family Member ..53. Communications Access Real-Time Translation (CART).

8 53. Foreign Language Interpreter ..53. Professional Interpreter ..53. Services Provided by Family Reader Services ..54. Technical/Complex Reader Services or Reader Services with Technology Access ..54. Translation Services ..54. Notetaker Services ..55. Chapter 10: Rehabilitation/Assistive Technology Goods, Services, and Training ..56. Vehicle, Residential, and Job Site Modification ..56. Vehicle Residential Modification ..56. Job Site Modification ..56. Informal Bid Process ..56. DVR Fee Schedule | April 2, 2018 Page v Assistive Technology Devices ..57. Professional Rehabilitation/Assistive Technology Services ..57. Design, Fabrication, Adaptation, and Customization Services ..57. Training and Consultation ..57. Hearing Technology Goods and Services ..57. Hearing Aids ..58. Cochlear Chapter 11: Self Employment Services ..62. Occupational Testing and Occupational Licenses and Occupational Tools and Equipment.

9 62. Initial Stock and Inventory ..62. Technical Assistance/Business Services and Consultation ..62. Informal Bid Process ..62. Allowable Funding for Self-Employment Start-Up Costs ..63. Tier I ..63. Tier II ..63. Chapter 12: Occupational Licenses, Tools, and Equipment ..64. Occupational Licenses and Occupational Tools and Equipment ..64. Informal Bid Process ..64. Technical Assistance ..64. Chapter 13: Pre-Employment Transition Services ..65. Pre-ETS Job Exploration Counseling ..65. Pre-ETS Job Exploration Pre-ETS Situational Assessment (SA) ..66. Pre-ETS Standardized Vocational Evaluation ..67. Pre-ETS Work-Based Learning Experiences ..67. Pre-ETS Paid Work-Based Learning Experiences ..68. Pre-ETS Community Based Site Set Up ..68. Pre-ETS Employer Expenses ..69. Pre-ETS Informational Interview, Job Site Tour or Job Pre-ETS Counseling on Comprehensive and Post-Secondary Education Programs.

10 69. Pre-ETS Workplace Readiness Training ..70. Pre-ETS Work Adjustment Training ..70. DVR Fee Schedule | April 2, 2018 Page vi Pre-ETS Personal Adjustment Training (PAT) ..71. Pre-ETS Orientation & Mobility Training ..72. Pre-ETS Communication Skills Training ..73. Pre-ETS Job Seeking Skills Training ..73. Pre-ETS Job Pre-ETS Curriculum-Based Workplace Readiness Training Program ..73. Pre-ETS Instruction in Self-Advocacy ..74. Pre-ETS Auxiliary Aids and Services ..74. Pre-ETS Communication Services ..74. Pre-ETS Reader Services ..76. Pre-ETS Notetaker Services ..76. Pre-ETS Purchase, Rental and Repair of Assistive Technology Devices ..76. Chapter 14: Job Search and Placement Services ..77. Tier I ..77. Tier II ..77. Job Placement Agreement ..78. Job Placement Plan ..78. Milestone 1: Job Preparation and Development ..79. Milestone 2: Job Placement.