School Based Services Medicaid Reimbursement

 

Medicaid is a jointly funded health insurance program between the Federal and State government for low-income families and persons with disabilities. School Based Services allows districts to receive partial reimbursement for services provided to students with special needs under the Individuals with Disabilities Education Act (IDEA). 

 

School Based Services consists of two programs:

 

Fee for Service Program

The Fee For Service Program offers partial reimbursement for direct medical services provided to special education students through the age of 21. Services that are eligible for reimbursement include:

 

·         Assistive Technology

·         Audiology

·         Case Management

·         Evaluations

·         Nursing

·         Occupational Therapy

·         Orientation & Mobility

·         Personal Care

·         Physical Therapy

·         Psychology

·         School Social Work

·         Specialized Transportation

·         Speech & Language Therapy

 

Administrative Outreach Program

The Administrative Outreach Program offers partial reimbursement for the cost of administrative activities that support efforts to identify and enroll potentially eligible persons into Medicaid and that are in support of the state Medicaid plan.

 

The Time Studies are conducted for School Based Services to track the time spent on direct service and outreach activities in support of special education students.  The results are then used in calculating the reimbursement claim.

 

 

 
 

 

 

Toni Sturgis

Medicaid Coordinator

(269) 789-2426

 

 

 

Resources:

This is a work in progress.  Documents will be added soon.

 

Medicaid Annual Notification

 

Consent for Medicaid SBS Form

 

Consent for Medicaid SBS PDF

 

Medicaid Consent Cover Letter

 

Medicaid Consent Forms in Spanish

 

School Based Services Brochure

 

Documentation Guidelines for Ancillary Staff

 

Documentation Guidelines for Case Managers

 

Personal Care Log

 

Provider Tip Sheets