Comprehensive Diagnostic Evaluation (CDE)

A Comprehensive Diagnostic Evaluation (CDE) is a thorough review and assessment of the child’s development and behavior using national, evidence-based practice standards, which may include:

• A parent or guardian interview

• Teacher Assessment

• Diagnostic testing using tools such as: o   Autism Diagnostic Observation Schedule (ADOS-2)

  • The Childhood Autism Rating Scale – 2nd edition (CARS2)

  • Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R)

  • Communication and Symbolic Behavior Scales (CSBS)

  • Autism Diagnostic Interview, Revised (ADI-R)

  • Social Communication Questionnaire

  • Battelle Developmental Inventory– 2nd edition

  • Hearing and vision testing

  • Genetic testing

  • Neurological and/or another medical testing

The CDE must be led by licensed practitioners qualified to assess child developmental disorders such as:

• Developmental Pediatricians

• Child Neurologists

• Child Psychologists

• Child Psychiatrists

Here are the circumstances in which a CDE is required for authorization of BA services:

• In order to initiate (for the first time) behavior analysis services, the Agency requires that the provider submit a copy of the child’s Comprehensive Diagnostic Evaluation (CDE), along with all other required documentation to eQHealth Solutions, Inc. The CDE will only be required to be submitted one time and the child will not have to obtain another CDE to continue services. 

• If a CDE has never been submitted with a previous authorization request. In these circumstances, the child does not have to get a new CDE if one was completed in their lifetime. The provider can submit the last CDE completed. If a CDE was never completed, eQHealth will extend the authorization to allow time for the child to obtain a CDE.

Alternative Assessments in Pilot Regions

Effective immediately, in order to initiate BA services while a child is waiting for his/her scheduled appointment for the CDE, eQHealth will accept the following documentation, in lieu of the CDE:

• Children 0 – 36 months of age: Early Intervention Services evaluation/Individual and Family Support Plan

• Children older than 36 months of age:

  • Individual Education Assessment (IEP) or school district assessment for IEP

  • Neurological evaluation

  • History and physical from a licensed physician documenting behaviors and evaluation conducted to ascertain the diagnosis

These alternative assessments do not replace the requirements for a CDE. If parents are having difficulty finding a provider to perform the CDE, their child’s health plan is available to help. Parents can also contact the Agency at 877-254-1055 and we will work with them or their child’s plan to find a provider.

Additional Resources and Information

• For assistance with obtaining prior authorization for behavior analysis services, please contact eQHealth Solutions at 1-855-444-3747.

• Additional questions from providers may be directed to the Florida Medicaid Helpline at 1-877-254-1055.