Medicaid Reimbursement for Vision and Hearing Screens Medicaid In The Schools (MITS) January 2008

Getting Started…  Vision Screens- Act 1438 (2006 school year) It is the purpose of this requirement to establish eye and vision screenings for students enrolled in pre-k, kindergarten, grade 1, 2, 4, 6, and 8, as well as all transfer students.  With the law came the opportunity to bill for the mandated screens, and then some.

What’s New?  Does not require a PCP referral for hearing or vision screens.  Screens completed by LPNs can be billed, if supervised by an RN.  Can bill for all students that have Medicaid, not just special education students.

Reimbursement Rates  Vision Screen$14.08  Hearing Screen$12.02

Getting Set-up to Bill  Need provider number for vision/hearing screens  Must complete provider enrollment application  Submit to MITS when complete  Copy with instructions on our website at

Billing Methodology Two ways to bill for screens and other services: 1. EDS or 2. MITS

EDS Billing  Requires the user to install software, install an external modem, have a customer service representative to set-up and train the district.  Free software, cost per transaction  User responsible for data entry, eligibility checks, and billing.

EDS Contact Information  Provider Representatives: lution/Provider/provreps/provreps.aspx lution/Provider/provreps/provreps.aspx  See Vender Booth for more information

MITS Billing  Requires an Interagency Agreement with district and MITS;  Requires district to complete a specific file and submit to MITS for effortless eligibility check and electronic billing. Electronic file includes student name, SSN, date of birth, and LEA #;  Fee for service (5 percent change than what the district is currently paying, but without the ease and time savings).

MITS Contact Information Tony Boaz Medicaid In The Schools (MITS) 2402 Wildwood, Suite 172 Sherwood, AR (866) , option 1 (Help Desk) (866) , option 2 or (501) (Program and Management Office)

Arkansas Medicaid Resource Information Arkansas Medicaid (800) ARKids First (888)