WV Birth to Three Vendor Information
WV Birth to Three (WVBTT) is a statewide system of services and supports through Part C of the Individuals with Disabilities Education Act (IDEA) for children under age three who have a diagnosed delay in their development or may be at risk of having a delay. The purpose of early intervention services is to assist parents and other primary caregivers to promote the participation of infants and toddlers with disabilities within the daily activities and routines of the child and family.
There may be times when concerns arise about a child's hearing or vision requiring evaluation and the use of appropriate assistive technology. For other children, the use of durable medical equipment may be necessary. The need for these services is determined by the WVBTT multi-disciplinary team, and the child's family.
Scheduling office visits or gathering quotes for durable medical equipment requires that you will work with a WVBTT Service Coordinator. An authorization for approved services will come from the WVBTT state office identifying what service/DME has been approved for the child. All services must be authorized by WVBTT prior to being rendered.
WVBTT System Categories of Services Covered
- Durable Medical Equipment (DME)
- Hearing Evaluations and Hearing DME
- Vision Evaluations and Vision DME
Services that are covered by the program must fall within the guidelines as set by Part C of the Individuals with Disabilities Education Act (IDEA) and are authorized specific to the educational service being requested.
Durable Medical Equipment (DME) - inluding, but not limited to:
- Identified WVBTT program covered items necessary in assisting a child with developmental delays.
- A written quote/estimate (if applicable) for recommended equipment must be provided as part of the approval process to obtain authorization.
- Wheelchairs, walkers, standers, gait trainers, strollers.
- Augmentative and Alternative Communications (AAC) devices.
- Other covered services as listed on the WVBTT DME Services Fee schedule.
Sample authorization for DME requested
Audiological Services - administered by a licensed Audiologist
- Initial authorization for a hearing evaluation is good for a six-month period; this allows for proper assessment to determine hearing loss.
- The WVBTT service coordinator will schedule the appointment for the initial evaluation and if there is a need for additional service, the family will work with the audiologist.
- If a child presents with an infection or earwax impaction preventing proper screening during an authorized initial visit, WVBTT will pay for that first visit. There must be documentation in the audiological report supporting the need for a return visit to complete the evaluation/assessment.
- Request a sedated ABR evaluation if not able to accurately obtain information under non-sedated ABR. (Anesthesia is not covered. It is considered a medical service.)
- Evaluation/assessment reports including recommendations for additional services (sedated ABR testing, hearing aids (monaural or binaural), or FM systems must be submitted to WV Birth to Three. Services conducted without prior authorization will not be covered.
- External hearing aids, batteries and supplies, and FM systems are covered until a child exits or transitions from the BTT program up to age three.
- Other services listed on the WVBTT Audiological Services Fee Schedule.
Sample authorization for hearing evaluation
Sample authorization for hearing aids
Vision Services - administered by a licensed Optometrist/Ophthalmologist
- Vision evaluations are for a single date of service to determine vision concerns.
- The WVBTT service coordinator will schedule the appointment for the initial evaluation and if there is a need for additional service, the family will work with the optometrist/ophthalmologist.
- Evaluation reports including recommendations for additional services, such as corrective lenses, must be submitted to WVBTT to obtain authorization. WVBTT will cover the expense for the first pair of glasses. Services conducted without prior authorization will not be covered.
- Other services listed on the WVBTT Vision Services Fee schedule.
Sample authorization for vision evaluation
Sample approval authorization for glasses
Not Covered Under the WVBTT System
- WVBTT does not cover medical treatments such as medical appointments for ear infection or impaction, ongoing otitis media, fluid drainage, placement of PE tubes or cochlear implants, and/or ongoing vision services following a child's first vision prescription.
- WVBTT does not cover shipping costs for items.
- WVBTT is a tax-exempt state program.
How to Bill for Services
Claims (invoices) must be submitted to WV Birth to Three using an original HICF1500 or UB04 form. WVBTT provides fee schedules for each category of services rendered. Codes are reviewed and are updated annually and when changes occur during the year, a new listing is provided.
- WVBTT uses Medicaid fee schedules to cover items and services that are necessary to assist a child with developmental delays.
- WVBTT fees are specific to the WVBTT program.
- WVBTT will return or deny claims that are submitted for services that are not covered or services billed for medical treatment.
Memorandum of Understanding (MOU)
The WV State Auditor's Office must have a Memorandum of Understanding (MOU) on file for vendors who are working with WV Birth to Three. An MOU is good for a period of three years. New vendors who wish to provide a service to WVBTT children will also need to complete an MOU prior to providing the service.
Payment for services provided will not occur until your MOU has been received by WVBTT. The MOU must be submitted in original form with signature in blue ink. If there are any changes that happen after your initial MOU submission, please contact the BTT Office Manager.
Documentation for Claim/Invoice Submission
All claims submitted to WVBTT for payment must include these attachments:
- A current WVBTT Service Authorization listing child's name and services approved by WVBTT.
- If audiological, authorization must have been issued within a six-month period from date of service.
- If vision, authorization is for one-time. A new authorization will be required for follow-up with recommendation for glasses.
- Equipment or items coded with a Miscellaneous fee code must have the manufacturer's itemized list attached to the claim.
- Equipment or items coded with an At Cost code must have the manufacturer's itemized list attached to the claim.
- Codes used from the WVBTT Fee Schedule will not require additional information.
Payment for Services
Each WVBTT vendor should be registered through the State of WV Electronic Funds Transfer (EFT) system. You must complete an application with the WV State Auditor's Office. If you have any questions about the EFT enrollment process, please email OSAFinanceGAAR@wv.gov.
WV BTT IS NOT AN INSURANCE COMPANY! Services that have been authorized through the program will be covered by WVBTT. Please do not send the insurance company Explanation of Payment (EOP) to WVBTT.
WVBTT Fee Schedules
When you accept the WVBTT authorization you agree to accept payment in full. You agree to the following:
- WVBTT services are paid according to current WV Medicaid codes and rates regardless of a child/family's financial ability.
- West Virginia Birth to Three nor the family is to be billed for missed appointments. (audiological or vision)
- Not to bill a WVBTT family or other funding sources for services provided through the program.
- WVBTT pays for services authorized by the WVBTT program. Claims submitted for unauthorized services will be returned and denied for payment.
Each WVBTT fee schedule has been "password protected" to accessed by vendors only. Please contact WVBTT to acquire this information if you have not yet received it.
WVBTT Audiological Fee Schedule
WVBTT Durable Medical Fee Schedule
WVBTT Vision Fee Schedule