Early Intensive Developmental and Behavioral Intervention (EIDBI) Provider Enrollment and Polices and Procedures

Early Intensive Developmental and Behavioral Intervention (EIDBI) Provider Enrollment and Polices and Procedures

Early Intensive Developmental and Behavioral Intervention (EIDBI)

​​Early Intensive Developmental and Behavioral Intervention (“EIDBI”) services offer medically necessary treatment to people under the age of 21 with autism spectrum disorder (“ASD”) or related conditions. The purpose of this service is to educate families of people with ASD, and improving the long-term quality of life of people with ASD by promoting independence and participation in their community and daily activities. 

Holt law provides complete provider enrollment with the Minnesota Department of Human Services for your EIDBI  / Early Intensive Developmental and Behavioral Intervention business including navigating all legal documents to run the business, internal business documents, training, insurance requirements, office requirements, background checks, and complete access to all required forms and compliance with DHS, Minnesota and Federal Law in a convenient electronic format for your use.

What do I need to start?

In order to enroll an every EIDBI agency must have an enrolled QSP OR Level I provider, employed by the agency, who has advanced certification in one of the approved DHS Treatment modalities. A Level 1 provider must be under supervision by a clinical supervisor, although technically the clinical supervisor would not need the advanced certification. Most commonly, EIDBI agencies enroll a Qualified Supervising Professionals (QSP) who has the advanced certification.

The Qualified Supervising Professionals (“QSP”) must meet the requirements listed in 7120C. This includes:

  1. at least 2,000 hours of supervised clinical experience or training in examining or treating people with ASD or a related condition or equivalent documented coursework at the graduate level by an accredited university in ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child development.
  2. a licensed mental health professional under Minnesota Statute 245.4871, subdivision 27, clauses (1) to
    (6) OR a developmental or behavioral pediatrician
  3. Certification in a DHS recognizes the following treatment modalities:

    Note: DHS may add other treatment modalities.

4. Proof showing you are qualified to provide EIDBI services, including but not limited to the following:

  • Licenses, Certifications, College Transcript(s) and Diplomas of practitioners to be listed

You could also enroll Level I, II or III providers using a combination of professionals. See here.


What is the process, and how long does it take?

To enroll as a EIDBI Agency here is a list of the process steps:

  • Ensure that your employees are not on the Office of Inspector General (OIG) Exclusion List. Keep this exclusion list for your own records.
  • Ensure that no person or entity identified on the Disclosure of Ownership and Control Interest of an Entity (DHS-5259) (PDF)form, or any other employees, are on the MHCP Excluded Provider Lists as an excluded group or individual provider.
  • Ensure your agency initiates a background study for all direct-care staff as required.
  • Complete and fax the following to MHCP Provider Enrollment at 651-431-7462:
  • MHCP Organization – Provider Enrollment Application (DHS-4016A) (PDF)
  • MHCP Provider Agreement (DHS-4138) (PDF)
  • Disclosure of Ownership and Control Interest (DHS-5259) (PDF) Qualified supervising professionals (QSPs) are considered managing employees as their work directs the day-to-day operations of the organization
  • Assurance Statement for EIDBI Provider Agencies (DHS-7120B) (PDF)
  • EIDBI Assurance Statement for Qualified Supervising Professionals (QSP) (DHS-7120C) (PDF)
  • Proof showing you are qualified to provide EIDBI services including, but not limited to, the following for the qualified supervising professionals:
  • Licenses
  • Certifications
  • College transcript(s)
  • Diplomas

The process generally takes 45 days from the date the Company has all of the required prerequisites. With information gathering and training in on legal forms the process usually takes 3 months from start to approval and starting to provide services.

How much does it cost?

Flat fee $3950 (does not include the required $688 filing fee – 2023).  Does not include filing fees. Does not include staffing or locating qualified professionals. Referrals may be provided.

EIDBI Rates/Reimbursement for Services:

  • Comprehensive Multi-Disciplinary Evaluation (CMDE): Behavior identification assessment / 97151 / 15 min / $43.58
  • Individual Treatment Plan (ITP) Development and Monitoring / H0032 / per encounter / $82.44
  • Coordinated Care Conference: Medical Team Conference / T1024 / per encounter / $97.87
  • Intervention–Individual: Adaptive behavior treatment by protocol / 97153 / 15 min / $17.54
  • Intervention–Group: Group adaptive behavior treatment by protocol / 97154 / 15 min / $5.84
  • Intervention–Higher intensity: Adaptive behavior treatment with modifications in protocol administered by two or more providers / 0373T / 15 min / $21.04
  • Intervention–Individual: Observation and Direction: Adaptive behavior treatment with protocol modification / 97155 / 15 min / $17.54
  • Family or Caregiver Training and Counseling –Individual: Family adaptive behavior treatment guidance / 97156 / 15 min / $17.54
  • Family or Caregiver Training and Counseling –Group: Multiple family group adaptive behavior treatment guidance / 97157 / 15 min / $5.84
  • Travel Time / H0046 / 1 min / $0.45


Can you help me find EIDBI qualified staff? No.

For more information on the EIDBI program – see below:

1)               See Early Intensive Developmental and Behavioral Intervention (EIDBI) Benefit Policy Manual

2)               See EIDBI Benefit Page

3)               EIDBI – Background and Summary Overview of MN Autism Benefit Program

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