Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 330.00 - Rates for Team Evaluation Services
Section 330.02 - Definitions
Assessment. A professionally sound, complete, and suitably individualized examination and assessment of a child's need for special education and treatment services described in 603 CMR 28.00: Special Education, in the context of the child's physical, developmental, social, and educational history and current circumstances. Such an assessment is rendered by an authorized professional as defined in 101 CMR 330.02 and trained in the area of suspected need and generally includes a written assessment report as defined in 101 CMR 330.02. Types of assessments may include, but are not limited to, the following.
(a) Medical Assessment. A comprehensive health assessment by an authorized physician that identifies medical problems that may affect the child's education, such as physical constraints, chronic illness, neurological and sensory deficits, and developmental dysfunction. The medical assessment generally includes at least the following:
1. a medical history to include health of family, prenatal and birth history, developmental history, and history of significant medical conditions, including hospitalization, injuries, and accidents;
2. a complete physical examination to include blood pressure and nutritional assessment;
3. neurological and developmental assessments to include gross motor functioning, fine motor functioning, language, visual and auditory functioning;
4. tests for visual acuity and hearing by audiometry;
5. the ordering and interpretation of diagnostic tests to include, if indicated, hematocrit or hemoglobin, sickle cell test (if appropriate), blood lead test, urinalysis (with culture for females), tuberculosis skin test, and other tests as indicated;
6. a dental assessment and referral for a complete dental examination, if one has not been done within six months; and
7. a written assessment report.
(b) Psychological Assessment. An assessment by an authorized psychologist or school psychologist including an individual psychological examination and culminating in specific recommendations. Sensory, motor, language, perceptual, attentional, cognitive, affective, attitudinal, self-image, interpersonal, behavioral, interest, and vocational factors are evaluated in regard to the child's maturity, integrity, and dynamic interaction within the educational context. The assessment is based on the child's developmental and social history, diagnostic observation of the child in familiar surroundings (such as a classroom), and psychological testing as indicated. Psychological testing may include, but is not limited to, a vocational interest evaluation, educational achievement testing, intelligence testing, personality evaluation, and neuropsychological examination.
(c) Home Assessment. An assessment by an authorized social worker, nurse, or counselor of pertinent family history and home situation factors including, with prior written parental consent, a home visit. This assessment includes a description of pertinent family history and individual developmental history and estimates of adaptive behavior at home, in the neighborhood, and in local peer groups. Estimates of adaptive behavior are based to the greatest possible degree on information obtained by direct observation of the child or direct interview of the child in the neighborhood setting.
(d) Educational Assessment. An assessment of the student's educational progress and status in relation to the general education curriculum consistent with 603 CMR 28.04(2): Initial Evaluation and conducted by a certified educator(s).
(e) Other Assessment. An assessment, other than a medical, psychological, or home assessment, by an authorized professional in a medically related area that is related to a child's suspected need for special education and services described in 603 CMR 28.00: Special Education. Such assessments, when necessary, may include, but are not limited to, assessments by a medical specialist (for example, a neurologist, a psychiatrist, or an ophthalmologist), a physical therapist, an occupational therapist, a speech pathologist, or an audiologist.
Authorized Professional. An individual who, at a minimum, meets the qualifications for the particular assessment services to be perforrmed as specified in 101 CMR 330.02(a) through (i), as well as such requirements as have been adopted by a governmental unit purchasing assessments from eligible providers.
(a) Medical Assessment Services. These services must be perforrmed by a pediatrician or other physician, other than an intern, resident, fellow, or house officer, who is licensed to practice by the Massachusetts Board of Registration in Medicine.
(b) Radiology Services. These services must be perforrmed by a licensed physician or licensed osteopath other than an intern, resident, fellow, or house officer.
(c) Psychological Assessment Services . These services must be perforrmed by
1. a psychologist who is licensed to practice by the Massachusetts Board of Registration of Psychologists; or
2. a school psychologist who is certified by the Massachusetts Department of Elementary and Secondary Education.
(d) Home Assessment Services. These services must be perforrmed by
1. a social worker who has a master's degree in social work and who is licensed by the Massachusetts Board of Registration of Social Workers as a. a certified social worker; or b. an independent clinical social worker;
2. a nurse who is registered by the Massachusetts Board of Registration in Nursing; or
3. a counselor who has a master's degree in counseling education, counseling psychology, or rehabilitation counseling.
(e) Medical Specialist Services. These services must be perforrmed by a physician, other than an intern, resident, fellow, or house officer, who is licensed to practice by the Massachusetts Board of Registration in Medicine.
(f) Restorative Services. These services must be perforrmed by
1. a physical therapist who is currently licensed by the Board of Registration in Allied Health Professions;
2. an occupational therapist who is currently licensed by the Board of Registration in Allied Health Professions; or
3. a speech pathologist who is currently licensed by the Board of Registration for Speech-language Pathology and Audiology.
(g) Rehabilitation Clinic Services. These services must be perforrmed by
1. a physical therapist who is currently licensed by the Board of Registration in Allied Health Professions;
2. an occupational therapist who is licensed by the Board of Registration in Allied Health Professions;
3. a speech pathologist who is currently licensed by the Board of Registration for Speech-language Pathology and Audiology; or
4. a physician who is licensed to practice by the Massachusetts Board of Registration in Medicine.
(h) Audiological Services. These services must be perforrmed by an audiologist who is currently licensed by the Board of Registration for Speech-language Pathology and Audiology.
(i) Educational Assessment Services. These services must be perforrmed by a teacher holding certification by the Massachusetts Department of Elementary and Secondary Education, or a licensed psychologist.
Comprehensive Neuropsychological Assessment.
(a) A comprehensive neurological assessment generally includes, but is not limited to
1. record review;
2. patient interview: presenting problems and history (medical, psychological, educational, vocational);
3. collateral interview(s) e.g., by a teacher or parent(s) of the child, as indicated;
4. testing of neuropsychological functions (attention, executive and other frontally based functions, language, visuoperceptual and visuoconstructional functions, memory, sensory functions, motor functions, some emotional and personality functions, and other functions as indicated); scoring and analysis; and interpretation of data;
5. educational assessment, as indicated;
6. integration of test results with information from interview(s) and records;
7. formulations of conclusions, diagnosis(es), and recommendations;
8. report preparation; and
9. a follow-up meeting to review findings.
(b) If a provider performs a comprehensive neuropsychological assessment, then the provider may not also bill for a neurobehavioral interview or a partial neuropsychological assessment. The allowed range of hours for this assessment is nine through 24 hours.
Comprehensive Pediatric (21 Years of Age and Younger) Restorative Evaluation. An all-inclusive, in-depth assessment of a child's medical condition and level of functioning and limitations by a physical, occupational, or speech pathologist, to determine the need for treatment and, if necessary, to develop a plan of treatment. This evaluation includes a written report.
EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A
Governmental Unit. The Commonwealth, any department, agency, board, or commission of the Commonwealth and any political subdivision of the Commonwealth. Governmental Units include public school departments.
Individual Consideration (I.C.). Those rates for authorized services that are determined by a governmental unit based upon the nature, extent, and need for such service and the degree of skill and time required for its provision. Providers must maintain adequate records to determine the appropriateness of their I.C. claims and must provide these documents to the purchasing agency upon demand.
Physician's Comprehensive Rehabilitation Evaluation. A cardiopulmonary, neuromuscular, orthopedic, functional assessment perforrmed at a rehabilitation clinic by a physician.
Psychological Testing. The use of standardized test instruments and procedures by an eligible provider in order to evaluate aspects of an individual's functioning including, but not limited to, aptitudes, educational achievements, cognitive processes, emotional conflicts, and type and degree of psychopathology. These tests must be published, valid, and in general use as defined by listing in the Mental Measurements Yearbook or by conforming to the Standards for Educational and Psychological Tests of the American Psychological Association.
Publicly Aided Individual. A person for whose mental and physical health evaluation, as defined by 603 CMR 28.00: Special Education, governmental units of the Commonwealth are in whole or in part liable under a statutory public program.
Team Evaluation. An evaluation by a multidisciplinary team that consists of assessments in all areas related to the child's suspected need for special education and services described in 603 CMR 28.00: Special Education. Such assessments may include, but are not limited to, a medical assessment and associated diagnostic medical laboratory and radiological testing, a psychological assessment, a home assessment, and such other assessments as may be required in a child's diagnosis. (For the purposes of 101 CMR 330.00, Team Evaluation excludes the educational assessment by the school department and the classroom assessment by a teacher defined in 603 CMR 28.00. Rates of payment for these assessments are not the subject of 101 CMR 330.00.) Independent evaluation services are included under the authority of 101 CMR 330.00.
Team Evaluation Services. The individual services comprising team evaluation assessments. This includes services perforrmed in independent team evaluation assessments.
Therapist Evaluation. Evaluation perforrmed by a physical therapist, an occupational therapist, or a speech pathologist at a rehabilitation clinic.
Written Assessment Report. A report summarizing in writing the procedures employed in an assessment, the results, and the diagnostic impression. This report defines in detail and in educationally relevant and common terms, the child's needs and offers explicit means of meeting those needs.
603 CMR 28.00: Special Education. Regulations for the implementation of M.G.L. c. 71B.
