Extended Care Health Option (ECHO)
Chapter 9
Section 9.1
Special Education And Other Services
Issue Date: July
3, 1997
Copyright: CPT only © 2006
American Medical Association (or such other date of publication
of CPT).
All Rights Reserved.
Revision: C-27,
July 26, 2018
1.0 CPT PROCEDURE
CODES
99199, 99600
2.0 POLICY
2.1 Special education,
within the meaning of such term as used in the Individuals with
Disabilities Education Act (IDEA) and its implementing regulations
and policies, may be cost-shared subject to all applicable Extended
Care Health Option (ECHO) requirements, and in particular, the requirement
that other public programs and facilities be used to the extent
available and adequate.
2.2 Identification of appropriate public facilities.
The local educational agency with responsibility for the beneficiary
is the sole public facility to provide public facility use certification
for special education services.
2.3 Services
cost-shared through the ECHO may be provided by an authorized institutional
or individual professional provider on an inpatient or outpatient
basis and rendered in the beneficiary’s natural environment. This
includes at home, at school, or other location that is suitable
for the type of services being rendered.
3.0 EXCLUSION
Special
education services are generally unavailable under the TRICARE Basic
Program except as authorized under Section 1079(a)(g) of Title 10
United States Code (USC), and when authorized are not eligible to
be cost-shared under ECHO.
4.0 EFFECTIVE
DATE
September 1, 2005.
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