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NYS Early Intervention Program Assistive Technology Medical Necessity Justification Form

NYS Early Intervention Program Assistive Technology Medical Necessity Justification Form 2025

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4.6 out of 5

38 votes

The document is a form for the New York State Early Intervention Program (NYS EIP) that assists service providers in justifying the medical necessity for assistive technology devices (ATD) for children. It outlines the process for requesting ATDs, including contacting regional TRAID Centers or Municipality Lending Closets, documenting device availability, and submitting necessary documentation to support Medicaid and private insurance billing. The form requires detailed information about the child, their diagnosed conditions, the requested ATD, its integration into daily routines, and collaboration with other service providers.

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Versions	Form popularity	Fillable & printable
2017	4.6 Satisfied (28 Votes)
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