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Nonverbal and Verbal Intelligence Quotient Testing – The child’s nonverbal or verbal intelligence quotient, as measured by a standardized test of intelligence, must be obtained as a requirement for preauthorization of services after 12 months from initiating services under the Demonstration has passed. However, if testing cannot be completed after 12 months and every six months thereafter, the child’s primary care physician or ASD specialist is required to submit an Eligibility Verification certifying the beneficiary is unable to participate in intelligence testing. The beneficiary's PCP or specialized ASD provider is required to recertify the beneficiary's continued inability to participate in or complete intelligence testing every six months.
Standardized diagnostic instruments accepted by TRICARE are:
- Wechsler Intelligence Scale for Children, 4th Edition (WISC-IV)
- Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition
- Differential Ability Scales (DAS II)
- Mullen Scales of Early Learning-AGS Edition (for children under 3 or with lower mental ages)
- Stanford-Binet Intelligence Scale, 5th Edition (SB5)
- Bayley Scales of Infant Development
- Leiter International Performance Scale- revised (LIPS-R)
Intelligence testing performed prior to demonstration enrollment is acceptable.
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