Additional Assessment

Purpose

Occasionally an additional assessment that is requested by the family, or that the provider recommends in the course of intervention/treatment.

Practice

Documentation and billing will be completed by the primary and should note that this stands as a separate document from a daily note for that day. Another way a provider may think of this is that they have completed a consult to themselves.

Procedure

Assessments are documented in a RainTree Consultation Note.

Complete the following tabs:

  • Observation: enter a complete a description of the assessment activity completed, write-up of observations made during the assessment
  • Summary of Findings: enter the interpretation and the recommendations
  • Charges
    • Objective Findings: enter the test/assessment results (if applicable)

Billing Codes

  • OT, PT, SLP Therapists
    • Developmental Eval
    • Health and Beh Assessment
  • Developmental Therapists and Social Workers
    • Nonbill eval