• Documentation of a developmental diagnosis.
  • A prescription dated within 12 months from the date of service signed and dated by the physician for each ADDT service identified as needed by the patient.
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  • Documentation of evaluations and assessments of the beneficiary that support each service listed on the IPP. 
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  • An Individual Program Plan (IPP) developed within 12 months of the date of service that is authorized by the physician determining that ADDT services are medically necessary.  The physician’s original personal signature and the date signed must be recorded on the IPP. 
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  • For each individual service provided the documentation must contain:
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    • A description of specific ADDT service(s) provided with:
    • Date and actual time service(s) were rendered
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    • The name(s) and title(s) of the individual(s) providing the service(s)
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    • The relationship of the services to the goals and objective described in the IPP

  • Weekly progress notes signed or initialed by the person providing services, including a description of each beneficiary status with respect to his or her goals and objectives
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  • If the patient is no longer receiving services, a copy of discharge notes and a summary are required.