On Target ABA · Telehealth Tools

Telehealth Evaluation — Procedure Guide

Operational steps to run at the start of every telehealth evaluation. The Addendum Generator tab handles the documentation; this tab is what to do live.

At the start of every initial session

Run these in order. Check off as you go.

Before turning the camera on

1
Confirm patient's physical location for today
Ask which address the patient is at right now — most often home, but sometimes work, grandparent's, school. Look up the nearest ER in Google Maps if you don't already know it. You'll need both for the verbal disclosure and to enter into the addendum.
2
Confirm written telehealth consent is on file
Check the intake packet. If not on file, do not proceed without written consent.
3
Start your time log
Start time begins the moment the encounter launches.

Once the parent joins

4
Verify identity on camera
Ask the parent to hold a photo ID up to the camera. Confirm name matches intake. Have parent introduce the child and confirm DOB; verify DOB plus one other identifier (member ID, parent name, or address) against the chart.
5
Confirm guardian presence
Guardian must be physically with the child for the entire patient-facing portion.
6
Read the verbal disclosure script (below) and obtain verbal consent
Required by Utah Code §26B-4-704(2)(d) and (e). Paraphrasing is fine, but every bolded element must be covered.

Verbal disclosure script — read aloud

Required by Utah Code §26B-4-704

"Before we start, I want to walk you through a few things about how telehealth works.
  • Telehealth depends on technology, which can fail — we can lose connection or video quality, and I may not see everything I would see in person.
  • You also have the option to seek in-person evaluation through another provider. Keep in mind that wait times for in-person autism evaluations are often very long — typically several months — so most families choose telehealth for that reason.
  • Electronic transmission carries some inherent risk even with a HIPAA-compliant platform.
  • If our connection drops, call me back at [provider's direct callback number]; for any medical emergency call 911 — the nearest emergency room to you is [ER name and address].
Do you have any questions? Do you consent to proceeding with today's evaluation via telehealth?"

During the session

7
Maintain synchronous audio and video
If either fails, pause and re-establish. Note any meaningful interruption.
8
Mark stop time the moment patient-facing activity ends
Before switching to scoring or notes. Scoring and writing go in separate rows of the time table.
9
Watch for telehealth-inappropriate situations
If clinical concerns arise that telehealth can't address (acute safety risk, child cannot engage with the modality), pause and discuss with the guardian. Document rationale; an in-person follow-up may be warranted.

Time tracking — what goes in each row

Every minute belongs to exactly one row — no overlap. Click each row to see what belongs.

Intake Interview — camera on, with caregiver

Face-to-face history-taking and clinical interview.

  • Reviewing reason for referral
  • Prenatal, birth, developmental, medical, family, psychosocial, treatment, academic, current-concerns history
  • DSM-5 clinical interview questions (ASD, ADHD, anxiety, mood, trauma)
  • Following up on developmental milestones, regression, prior school/therapy services
  • Initial behavioral observations of the child made while the parent is being interviewed
Test Admin & Observation — camera on, with child

Face-to-face time administering standardized instruments and structured observation of the child.

  • Administering CARS-2 (HF or ST) via structured observation and probing
  • Going through parent-report items live with the parent (CARS2-QPC, GARS-3, SCQ, Vanderbilt)
  • Play-based observation tasks (Lego imitation, play kitchen, joint-attention, transitions)
  • Behavioral observation of social responsiveness, eye contact, stimming, echolalia, response to name
  • Probing receptive/expressive language
  • Coaching parents in real time to elicit behaviors
Scoring — camera off, patient not present

Computing scores from the instruments you administered.

  • CARS-2 total raw, T-score, percentile
  • GARS-3 Autism Index, subscales, severity level
  • SCQ total vs. cutoff
  • Vanderbilt subscale totals and clinical-cutoff rules
  • Plotting standardized scores / score-summary tables
  • Finalizing item ratings (e.g., assigning 1–4 CARS-2 ratings from observation notes)
Report Writing — camera off, patient not present

Clinical thinking, integration, and writing.

  • Reviewing prior records (pediatric notes, IEPs, prior speech/OT evaluations)
  • Integrating data across all sources
  • Mapping observations to DSM-5 criteria (A1, A2, A3 / B1, B2, B3, B4)
  • Differential diagnosis decision-making
  • Determining ASD severity level and writing rationale
  • Drafting all narrative sections
  • Formulating recommendations and treatment planning
  • Final review and edit before signing

Quick rules: Producing data → Test Admin (camera on) or Scoring (camera off). Thinking about what data means → Report Writing. Coaching parent to elicit behavior → Test Admin. Each row in the time table is one continuous block; if you do two intake sessions on the same day (morning and afternoon) or split work across days, use a separate row for each session — the form sums daily totals automatically for billing limits.

After the session

  • Use the Addendum Generator tab to produce the compliance addendum. Sign, then copy/download/print and attach to the main report.

Telehealth Evaluation Compliance Addendum — Generator

Fill in the form, then e-sign in the signature panel. The signed addendum can be copied, downloaded, or saved as PDF.

Privacy: Everything you type stays in your browser. Nothing is sent to any external server. Patient and guardian data are never saved. Opting in to "Remember my provider info" saves only your provider credentials, locally on this device.

Provider Credentials

Provider Location (distant site)

Name, license, APIT, and provider address only. Patient and guardian data are never saved.

Patient Information

Determines which statutes the addendum cites (Utah Code §26B-4-704 vs. Ohio Administrative Code 5160-1-18 / 5122-29-31). PSYPACT APIT covers practice in both states.

Encounter Details

Designated PCP

Professional Time

Each row is one continuous session. A single calendar date can have multiple sessions of the same activity (e.g., morning intake + afternoon intake). Use "+ Add another session" for additional rows. See the Procedure Guide tab for what goes in each activity.

GRAND TOTAL: 0 min

Addendum Preview

Click anywhere in the preview to edit text directly. Form changes won't overwrite your edits — use "Regenerate" to start fresh. Signature is required before copy/download/print.

Unsigned. Sign the document below to enable Copy, Download, and Print.

E-Signature REQUIRED

Signature is required. Identity check + content hash + audit trail are embedded in the signature block, which is appended to the addendum as part of the legal record.
Signing name:
Credentials:
Identity verification:
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