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Published byEaster Kelly Modified over 8 years ago
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Medicaid Reimbursement for IEP Services
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IN Medicaid-covered IEP Services
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IEP-required R.N. services and Special Ed Transportation Just added:
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What documentation is required? Documentation that a direct medical service was provided to an eligible Special Education student e.g., paper or electronic Service Log; Student Record Medical Necessity Documentation e.g., physician order; assessments; treatment plan/IHP General School Corporation Records e.g., financial; student & staff attendance; licensure Details online in the Medicaid Billing Tool Kit
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Watch for Tool Kit Updates
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There must be an order or referral for therapy and nursing services that are billed to Medicaid. The School Psychologist practice act, IC 20-28-1-11, defines “School Psychology” to include referring a student to: “(A) a speech-language pathologist or an audiologist licensed under IC 25-35.6 for services for speech, hearing, and language disorders; or (B) an occupational therapist licensed under IC 25-23.5 for occupational therapy services” Required Referral for Medicaid- reimbursed IEP Services
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How does reimbursement work? Every Medicaid check = state + federal funds –At present: each Medicaid payment includes 75% federal & 25% state dollars –State funds “draw down” additional federal $ –Medicaid-participating school corporations recover a portion of their costs for providing Medicaid-covered health-related services to students with an Individualized Education Program (IEP)
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Medicaid reimbursement example
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How Many School Corps Bill? In Fiscal Year 2009: 71 In Fiscal Year 2010: 110
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http://www.doe.in.gov/exceptional/speced/docs/SchoolCorpMedicaidReport.pdf Which Corporations Participate?
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What resources are available? The Medicaid Billing Tool Kit & Guide Presentations, bulletins, reports Articles, Q&A, Newsletters Sample Forms Parent Information Brochure VISIT: http://www.doe.in.gov/exceptional/speced/medicaid.html
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IDOE’s Medicaid Web Page
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National Resources on School- based Medicaid Services http://medicaidforeducation.org/ http://www.theleanet.com/
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