Current Effective Date:
Revised 04/89; 03/90; 11/91; 02/93; 06/93; 10/01; 02/08
The Vocational Rehabilitation Counselor is instructed to review existing data to determine needed information and to discuss the proposed testing with the eligible individual. The Vocational Rehabilitation Counselor should then decide what kind of psychological information is necessary for evaluation purposes and for the development of the Individual Plan for Employment (IPE) (On-Line DSB-4005b-VR Individual Plan for Employment with instructions).
Listed in this policy are the types most often requested for eligible individuals and should be adequate for most programming needs. The maximum fee is set and cannot be exceeded or prevailing Medicaid rates if no specific rate is listed. If reports of psychological evaluations do not contain all of the variables listed for the particular fee, the invoice will be graded at a lower rate.
Evaluation of an emotional disorder requires examination by a physician certified by the State and skilled in the diagnosis and treatment of such disorders or by a Licensed Psychologist (LP), Licensed Psychological Associate (LPA), or Licensed Professional Counselor (LPC) with specialization in Mental Health Counseling.
Complete psychological evaluations should include assessment of intellectual abilities; basic academic skills; personality concerns pertinent to Vocational Rehabilitation (VR) Services; vocational interests; and recommendations regarding psychological, psychiatric, and VR services.
Vocational Rehabilitation Counselors should access all comparable benefits that are available to each eligible individual. If outpatient therapy is available through the public Mental Health System, this would be a comparable benefit.
Intellectual abilities should be assessed using professionally recognized, individually administered instruments. Currently, the only acceptable instruments are the Wechsler Adult Intelligence Scale-Revised (WAIS-III or WAIS-IV), the Wechsler Intelligence Scale for Children-Revised (WISC-IV), or the Stanford Binet and its adaptations for the blind. Reports should include sub-test scale scores. Reports must include EITHER the range of intellectual ability and a percentile score (e.g., average range at the 50th percentile) OR an intelligence quotient with confidence limits.
Academic skills should be assessed using a professionally recognized instrument in a form (large print, Braille, tape, oral, or regular print) appropriate for the individual; reports should indicate the form used. Appropriate instruments include the Wide Range Achievement Test-Revised (WRAT-4), Key Math, Woodcock Johnson, Peabody Individual Achievement Test (PIAT), or other appropriate professionally recognized individually administered academic achievement test.
For the purposes of this standard, personality concerns are to be assessed at least as they relate to the individual's VR program or need for other services. The minimum criterion is a clinical interview and observation of the individual's behavior. Ordinarily, additional assessment techniques can be used. When the individual has sufficient reading and writing skills, a sentence completion form is to be used. At the discretion of the psychologist, instruments such as the Beck Depression Inventory, the 16PF or other appropriate personality assessment may be utilized. The report should describe any problems identified with anxiety, depression, suicidal ideation, psychotic process, thought disorder, mood disorder, need for further psychological or psychiatric evaluation and/or therapeutic services needed.
When the individual's reading skills are sufficient, vocational interests may be assessed using professionally recognized standardized measures such as the Career Assessment Inventory (CAI), the enhanced CAI, the Strong Vocational Interest Inventory or other vocational interest assessments. When these instruments are inappropriate, more extensive interviewing and recommendations about vocational alternatives would be expected.
Types of Psychological Evaluations:
1. Intellectual Assessment Only - Fee $125.00
Only individually administered intellectual instruments will be authorized (WAIS-III or WAIS-IV, WISC-IV, or Stanford Binet with adaptations for the blind). The psychologist must report all sub-test scores, unless the individual's limitations preclude administering all portions of the instrument. Reports must include diagnosis or clinical impression. Reports must include EITHER the range of intellectual ability and a percentile score (e.g., average at the 50th percentile) OR an intelligence quotient with confidence limits.
(Intellectual assessment with brief interview and record review - $125.00. Such a limited evaluation would be encountered where an updated intellectual assessment is required for the individual to be admitted to a special program such as ADAP, supported work, etc.)
2. Personality Assessment Only - Fee $125.00
Report must include:
Note: If a personality instrument such as 16PF or other appropriate personality inventory is administered in addition to a projective instrument and clinical interview, fee is $125.00.
3. Partial Evaluation (Full Evaluation except for Intelligence Test) - Fee $125.00
4. Partial Evaluation (Including Intelligence Test) - Fee $225.00
5. Complete Evaluation - Fee $275.00
NOTE: $25.00 additional fee for the 16PF or other appropriate personality inventory.
6. Special Evaluations and Consultation - By Report (This is given based on information from 3, 4, or 5.)
Neuropsychological evaluations will be graded by report at $105.70 per individual contact hour. Before authorizing neuropsychological evaluation, the individual must be administered a complete battery, and the report staffed with the Chief, Vocational Programs and Facilities, and if feasible, the Staff Psychologist for the Evaluation Unit.
NOTE: Textbooks state that the full Halstead-Reitan Neuropsychological Test Battery generally takes five hours to administer. The full Luria Nebraska Test generally takes three hours to administer. Certain individual conditions may require longer testing periods, but the Agency will not authorize pay for more than eight hours of neuropsychological testing ($846.60) for an individual.
Psychological consultations may be necessary to review previous psychological evaluations with the eligible individual in lieu of additional testing or to discuss the results of the current evaluation if there are findings that may be critical for the individual to hear directly from the psychologist. The rate for this consultation will be $27.50 per 30 minute consultation.
1. Individual: Rate based on current Medicaid rates. A written progress report related to the specified vocational disability shall be provided the Vocational Rehabilitation Counselor after every session and at conclusion of treatment. Vocational Rehabilitation Counselors may authorize up to six (6) sessions of psychotherapy. In unusual cases, an additional six (6) sessions may be authorized.
2. Group: Rate based on current Medicaid rates. Examples are Cognitive Training, Group Therapy Assistance, other Group Work (for example, assertiveness training). A written progress report shall be provided to the Vocational Rehabilitation Counselor at the conclusion of the treatment.
Other forms of individual psychological services are paid at Medicaid rates with a maximum of six (6) individuals per group. Example--cognitive training or anger management. (The instructor must be qualified with specialized training in identified area). A written progress report shall be provided to the Vocational Rehabilitation Counselor after every session and at the conclusion of treatment.
It must be emphasized that psychotherapy can only be sponsored if is required by the individual so that the objectives of the IPE can be achieved.
For questions or clarification on any of the policy contained in these manuals, please contact the local district office.