CHAPTER 30. MEDICAL PROVIDERS-FEE FOR SERVICE SUBCHAPTER 5. INDIVIDUAL PROVIDERS AND SPECIALTIES PART 103
|
|
- Shanon Todd
- 4 years ago
- Views:
Transcription
1 CHAPTER 30. MEDICAL PROVIDERS-FEE FOR SERVICE SUBCHAPTER 5. INDIVIDUAL PROVIDERS AND SPECIALTIES PART 103. QUALIFIED SCHOOLS AS PROVIDERS OF HEALTH RELATED SERVICES 317: Coverage by category (a) Adults. There is no coverage for services rendered to adults. (b) Children. Payment is made for compensable services rendered by local, regional, and state educational services agencies as defined by IDEA: (1) Child health screening examination. An initial screening may be requested by an eligible individual at any time and must be provided without regard to whether the individual's age coincides with the established periodicity schedule. Coordination referral is made to the SoonerCare SoonerCare provider to assure at a minimum, that periodic screens are scheduled and provided in accordance with the periodicity schedule following the initial screening. (2) Child health encounter. The child health encounter may include a diagnosis and treatment encounter, a follow-up health encounter, or a home visit. A Child Health Encounter may include a child health history, physical examination, developmental assessment, nutrition assessment and counseling, social assessment and counseling, genetic evaluation and counseling, indicated laboratory and screening tests, screening for appropriate immunizations, health counseling and treatment of childhood illness and conditions. (3) Hearing and Hearing Aid evaluation. Hearing evaluation includes pure tone air, bone and speech audiometry provided by a state licensed audiologist who: (A) holds a certificate of clinical competence from the American Speech and Hearing Association; or (B) has completed the equivalent educational (C) has completed the academic program and is acquiring supervised work experience to qualify for the certificate. (4) Audiometry test. Audiometric test (Immittance [Impedance] audiometry or tympanometry) includes bilateral assessment of middle ear status and reflex studies (when appropriate) provided by a state licensed audiologist who: 1
2 (A) holds a certificate of clinical competence from the American Speech and Hearing Association; or (B) has completed the equivalent educational (C) has completed the academic program and is acquiring supervised work experience to qualify for the certificate. (5) Ear impression (for earmold). Ear impression (for earmold) includes taking impression of a client's ear and providing a finished earmold which is used with the client's hearing aid provided by a state licensed audiologist who: (A) holds a certificate of clinical competence from the American Speech and Hearing Association; or (B) has completed the equivalent educational (C) has completed the academic program and is acquiring supervised work experience to qualify for the certificate. (6) Vision Screening. Vision screening examination must be provided by a state licensed Doctor of Optometry (O.D.) or licensed physician specializing in ophthalmology (M.D. or D.O.). At a minimum, vision services include diagnosis and treatment for defects in vision. (7) Speech Language evaluation. Speech Language evaluation must be provided by state licensed speech language pathologist who: (A) holds a certificate of clinical competence from the American Speech and Hearing Association; or (B) has completed the equivalent educational (C) has completed the academic program and is acquiring supervised work experience to qualify for the certificate. (8) Physical Therapy evaluation. Physical Therapy evaluation must be provided by a state licensed physical therapist. (9) Occupational Therapy evaluation. Occupational Therapy evaluation must be provided by a state licensed occupational therapist. (10) Psychological Evaluation and Testing. Psychological Evaluation and Testing must be provided by state licensed, Board Certified, Psychologist or School 2
3 Psychologist certified by State Department of Education (SDE). (11) Dental Screening Examination. Screening for dental disease by a state licensed dentist. The child may be referred directly to a dentist for further screening and/or treatment. (12) Child guidance treatment encounter. A child guidance treatment encounter may occur through the provision of individual, family, or group treatment services to children who are identified as having specific disorders or delays in development, emotional, or behavioral problems, or disorders of speech, language or hearing. These types of encounters are initiated following the completion of a diagnostic encounter and subsequent development of a treatment plan, or as a result of an IEP or IFSP and may include the following: (A) Hearing and Vision Services. Hearing and vision services may include provision of habilitation activities, such as auditory training, aural and visual habilitation training, including Braille, and communication management, orientation and mobility, counseling for vision and hearing losses and disorders. Services must be provided by: (i) state licensed, Master's Degree Audiologist who: (I) holds a certificate of clinical competence from the American Speech and Hearing Association; or (II) has completed the equivalent educational requirements and work experience necessary for the (III) has completed the academic program and is acquiring supervised work experience to qualify for the certificate; (ii) state licensed, Master's Degree Speech Language Pathologist who: (I) holds a certificate of clinical competence from the American Speech and Hearing Association; or (II) has completed the equivalent educational requirements and work experience necessary for the (III) has completed the academic program and is acquiring supervised work experience to qualify for the certificate; 3
4 (iii) state certified Speech Therapist working under the direction of a state licensed Speech Language Pathologist; (iv) state certified deaf education teacher; (v) certified orientation and mobility specialists; and (vi) state certified vision impairment teachers. (B) Speech Language Therapy Services. Speech Language Therapy Services must be provided by a state licensed Speech Language Pathologist who: (i) holds a certificate of clinical competence from the American Speech and Hearing Association; or (ii) has completed the equivalent educational (iii) has completed the academic program and is acquiring supervised work experience to qualify for the (iv) a Speech Therapy Assistant who has been authorized by the Board of Examiners, working under the direction of a state licensed speech language pathologist. The licensed Speech Language Pathologist may not supervise more that two Speech Therapy assistants, and must be on site. (C) Physical Therapy Services. Physical Therapy Services must be provided by state licensed physical therapist or a Physical Therapy Assistant who has been authorized by the Board of Examiners working under the supervision of a licensed Physical Therapist. The licensed Physical Therapist may not supervise more than three Physical Therapy Assistants. (D) Occupational Therapy Services. Occupational therapy may include provision of services to improve, develop or who restore impaired ability to function independently and must be provided by a state licensed Occupational Therapist or an Occupational Therapy Assistant who has been authorized by the Board of Examiners, working under the supervision of a licensed Occupational Therapist. (E) Nursing Services. Nursing Services may include provision of services to protect the health status of children, correct health problems and assist in removing or modifying health related barriers and must be provided by a registered nurse or licensed 4
5 practical nurse under supervision of a registered nurse. Services include medically necessary procedures rendered at the school site, such as catheterization, suctioning, administration and monitoring of medication. (F) Psychological Services. Psychological services are planning and managing a program of psychological services, including the provision of counseling for children and parents, consulting on management of severe behavioral and emotional concerns in school and home. All services must be for the direct benefit of the child. Psychological services must be provided by a state licensed Psychologist, or School Psychologist certified by SDE. (G) Psychotherapy Counseling Services. Psychotherapy counseling services are the provision of counseling for children and parents. All services must be for the direct benefit of the child. Psychotherapy counseling services must be provided by a state licensed Social Worker, a state Licensed Professional Counselor, a State licensed Psychologist or School Psychologist certified by the SDE, a State licensed Marriage and Family Therapist or a State licensed Behavioral Practitioner, or under Board supervision to be licensed in one of the above stated areas. (H) Assistive Technology. Assistive technology are the provision of services that help to select a device and assist a student with disability(ies) to use an Assistive technology device including coordination with other therapies and training of child and caregiver. Services must be provided by a: (i) state licensed, Speech Language Pathologist who: (I) holds a certificate of clinical competence from the American Speech and Hearing Association; or (II) has completed the equivalent educational requirements and work experience necessary for the (III) has completed the academic program and is acquiring supervised work experience to qualify for the certificate; (ii) state licensed Physical Therapist; or (iii) state licensed Occupational Therapist. (13) Personal Care. Provision of personal care services allow students with disabilities to safely attend school; includes, but is not limited to assistance with 5
6 toileting, feeding, positioning, hygiene, and riding school bus to handle medical or physical emergencies. Services must be provided by registered paraprofessionals/assistants who have completed training approved or provided by SDE, or Personal Care Assistants, including Licensed Practical Nurses, who have completed on-the-job training specific to their duties. (14) Therapeutic Behavioral Services. Therapeutic behavioral services is an intervention to modify the non-adaptive behavior necessary to improve the student s ability to function in the community as identified on the plan of care. Medical necessity must be identified and documented through assessment and evaluation. Services encompass behavioral management, redirection, and assistance in acquiring, retaining, improving, and generalizing socialization, communication and adaptive skills. This service must be provided by a Behavioral Health School Aide (BHSA) who has a high school diploma or equivalent and has successfully completed the paraprofessional training approved by The State Department of Education and a training curriculum in behavioral interventions for Pervasive Developmental Disorders as recognized by OHCA. BHSA must be supervised by a bachelor s level individual with a special education certification. BHSA must have CPR and First Aid certification. Six additional hours of related continuing education is required per year. (14) (15) Immunization. Immunizations must be coordinated with the Primary Care Physician for those Medicaid eligible children enrolled in SoonerCare. An administration fee, only, can be paid for immunizations provided by the schools. (c) Individuals eligible for Part B of Medicare. EPSDT school health related services provided to Medicare eligible recipients are billed directly to the fiscal agent. 317: Billing The following units are billed on the appropriate claim form: (1) Service: Child Health Screening; Unit: Completed comprehensive screening. (2) Service: Interperiodic Child Health Screening; Unit: Completed interperiodic screening. (3) Service: Child Health Encounter; Unit: 5-10 minutes equals 1 unit; minutes equals 2 units; over 21 6
7 minutes equals 3 units; limited to 30 units per year, additional units must be prior authorized. (4) Service: Individual Treatment Encounter for IEP School Based and School Based; Unit: 15 minutes, unless otherwise specified. (A) Hearing and Vision Services, IEP School Based. (B) Hearing and Vision Services, School Based. (C) Speech Language Therapy, IEP School Based. (D) Speech Language Therapy, School Based. (E) Physical Therapy, IEP School Based. (F) Physical Therapy, School Based. (G) Occupational Therapy, IEP School Based. (H) Occupational Therapy, School Based. (I) Nursing Services, IEP School Based; Unit: 5 minutes equals 1 unit; limited to 24 per day. (J) Nursing Services, School Based; Unit: 5 minutes equals 1 unit; limited to 24 per day. (K) Psychological Services, IEP School Based. (L) Psychological Services, School Based. (M) Psychotherapy Counseling Services, IEP School Based. (N) Psychotherapy Counseling Services, School Based. (O) Assistive Technology, IEP School Based. (P) Assistive Technology, School Based. (Q) Dental Screening, IEP School Based. (R) Dental Screening, School Based. (S) Therapeutic Behavioral Services, IEP School Based; limited to 12 units per day. (5) Service: Group Treatment Encounter for IEP School Based and School Based; No more than 5 recipients per group, Unit: 15 minutes, unless otherwise specified. (A) Hearing and Vision Services, IEP School Based. (B) Hearing and Vision Services, School Based. (C) Speech Language Therapy, IEP School Based. (D) Speech Language Therapy, School Based. (E) Physical Therapy, IEP School Based. (F) Physical Therapy, School Based. (G) Occupational Therapy, IEP School Based. (H) Occupational Therapy, School Based. (I) Psychological Services, IEP School Based. (J) Psychological Services, School Based. (K) Psychotherapy Counseling Services, IEP School Based. (L) Psychotherapy Counseling Services, School Based. (6) Service: Administration only, Immunization; Unit: one administration. 7
8 (7) Service: Hearing Evaluation; Unit: Completed Evaluation. (8) Service: Hearing Aid Evaluation; Unit: Completed Evaluation. (9) Service: Audiometric Test (Impedance); Unit: Completed Test (Both Ears). (10) Service: Tympanometry and acoustic reflexes. (11) Service: Ear Impression Mold; Unit: 2 molds (one per ear). (12) Service: Vision Screening; Unit: one examination, by state licensed O.D., M.D., or D.O. (13) Service: Speech Language Evaluation; Unit: one evaluation. (14) Service: Physical Therapy Evaluation; Unit: one evaluation. (15) Service: Occupational Therapy Evaluation; Unit: one evaluation. (16) Service: Psychological Evaluation and Testing; Unit: one hour (with written report). (17) Service: Personal Care Services; Unit: 10 minutes. 8
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Current Approved State Plan Language
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Current Approved State Plan Language Limitations on Attachment 3.1-A Page 9 Type of Service Covered for Medi-Cal eligibles under 21 years
Infant & Toddler Connections of Virginia DRAFT Provider Qualifications 1 Table
Infant & Toddler Connections of Virginia DRAFT Provider Qualifications 1 Table Audiologist Master s degree plus state licensure Specialist Associate Assistant Screening Audiology, Certified Therapeutic
MATRIX -School Based Child Health MSI Codes and Descriptions
MATRIX -School Based Child Health s and Descriptions AUDIOLOGY 22 27 Hearing screening 23 28 Hearing service, miscellaneous under the direction of the Audiologist under the direction of the Audiologist,
ATTACHMENT 3 REQUIREMENTS FOR PROFESSIONAL AND ASSOCIATE LEVEL EARLY INTERVENTION CREDENTIALING AND ENROLLMENT TO BILL
ATTACHMENT 3 REQUIREMENTS FOR PROFESSIONAL AND ASSOCIATE LEVEL EARLY INTERVENTION CREDENTIALING AND ENROLLMENT TO BILL Please monitor the EI website at www.dhs.state.il.us/ei for changes to Credentialing
AL-12-003 Attachment 3.1-A Page 2.4b
Page 2.4b 4.b. Early and periodic screening, diagnosis and treatment services for individuals under 21 years of age, and treatment of conditions found. --- (Continued) Effective Date: 04/01/90 (4) Hearing
NEW HAMPSHIRE CODE OF ADMINISTRATIVE RULES. PART He-M 1301 MEDICAL ASSISTANCE SERVICES PROVIDED BY EDUCATION AGENCIES
CHAPTER He-M 1300 SPECIALIZED SERVICES PART He-M 1301 MEDICAL ASSISTANCE SERVICES PROVIDED BY EDUCATION AGENCIES Statutory Authority: RSA 186-C:27; I-II He-M 1301.01 Purpose. The purpose of these rules
CALIFORNIA SPECIAL EDUCATION MANAGEMENT INFORMATION SYSTEM (CASEMIS) SERVICE DESCRIPTIONS. San Diego Unified SELPA
210 Family training, counseling, and home visits(ages 0-2 only): This service includes: services provided by social workers, psychologists, or other qualified personnel to assist the family in understanding
PART I DEPARTMENT OF PERSONNEL SERVICES 6.342 STATE OF HAWAII 6.343... 6.344. Class Specifications for the AUDIOLOGY SERIES
PART I DEPARTMENT OF PERSONNEL SERVICES 6.342 STATE OF HAWAII 6.343............................. 6.344 Class Specifications for the AUDIOLOGY SERIES This series includes all classes of positions, the duties
Nursing facility services require prior authorization from the Nevada Medicaid Office.
Attachment 3.1-A Page 2a 4.a. Nursing facility services require prior authorization from the Nevada Medicaid Office. 4.b. Early Periodic Screening, Diagnostic, and Treatment (EPSDT) services as defined
EPSDT SCHOOL-BASED SERVICES: AN OVERVIEW FOR PROVIDERS. Oklahoma Health Care Authority Revised May 2004
EPSDT SCHOOL-BASED SERVICES: AN OVERVIEW FOR PROVIDERS Oklahoma Health Care Authority Purpose of Manual This manual is intended as a reference document for schools that are enrolled as Medicaid providers.
SPECIAL EDUCATION AND RELATED SERVICES
i SPECIAL EDUCATION AND RELATED SERVICES Updated May 2008 i It is the policy of the South Dakota Department of Education, Office of Educational Services and Supports to provide services to all persons
POLICY 4060 MEDICAID REIMBURSEMENT FOR HEALTH-RELATED SERVICES. I. Policy Statement
BOARD OF EDUCATION POLICY 4060 MEDICAID REIMBURSEMENT FOR HEALTH-RELATED SERVICES Effective: July 1, 2009 I. Policy Statement The Board of Education recognizes its responsibilities to provide services
As compared to the PD-6 form for 2010-2011, the PD-6 form for 2011-2012 is identical
THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234 OFFICE OF P-12 (SPECIAL EDUCATION) INFORMATION AND REPORTING SERVICES (IRS) 89 WASHINGTON AVENUE RM 881 EBA ALBANY,
Related Services: How Do Special Needs Education Relate to Your Child?
Related Services: How Do Special Needs Education Relate to Your Child? Family Driven Non-Profit 501(c)3 What makes FND unique is that the majority of our Board of Directors, all of our Management Staff
PRESCHOOL PLACEMENT CATEGORIES
PRESCHOOL PLACEMENT CATEGORIES CASEMIS 20 EARLY CHILDHOOD SPECIAL EDUCATION SETTING Early Childhood Special Education Setting: This is a placement setting where children receive all of their special education
Early Intervention Service Procedure Codes, Limits and Rates
BABIES INFORMATION AND BILLING SYSTEM Early Intervention Service Procedure Codes, Limits and Rates Georgia Department of Public Health Office of Maternal and Child Health Children and Youth with Special
Perkins Cancellation
FEDERAL STUDENT AID HANDBOOK Volume 6 Managing Campus-Based Programs, 2011 2012 http://ifap.ed.gov/fsahandbook/attachments/1112fsahbkvol6ch5.pdf THIS IS AN EXCERPT FROM VOLUME 6, CHAPTER 5 CHAPTER 5 Perkins
The following table details the requirements applicable to practice a discipline in California for the positions listed.
Professional Requirements DDS and CDE share the responsibility for ensuring that all personnel under California's Early Start Program meet the current qualifications in statute, regulations, and policy.
4. PROGRAM REQUIREMENTS
TABLE OF CONTENTS iv 4. PROGRAM REQUIREMENTS 413.401: Introduction... 4-1 413.402: Definitions... 4-1 413.403: Eligible Members... 4-3 413.404: Provider Eligibility... 4-3 413.405: Services Provided by
Provider Qualifications
Provider Qualifications The following establishes general qualifications for providers by type of service. Additional qualifications may need to be met depending on the program and related funding source
Local Education Agency
KANSAS MEDICAL ASSISTANCE PROGRAM PROVIDER MANUAL Local Education Agency Updated 08/07 PART II Introduction Section BILLING INSTRUCTIONS Page 7000 Local Education Agency Billing Instructions...........
SCHOOL HEALTH SERVICES PROGRAM PROGRAM MANUAL
SCHOOL HEALTH SERVICES PROGRAM PROGRAM MANUAL Section 2 Covered Services The School Health Services Program is a joint effort between the Colorado Department of Education and Department of Health Care
Services which exceed the limitations as listed in the policies and procedures manual must be approved prior to service delivery.
Attachment 3.1-A Page 1i 4.b. EPSDT Related Rehabilitative Services Community Based (continued) Speech-Language Pathology Services Speech-language evaluation of auditory processing, expressive and receptive
Early Intervention For children ages 0-3 years
Early Intervention For children ages 0-3 years IDEA 2004 AND CHILDREN WHO ARE DEAF OR HARD OF HEARING Early intervention, serving children from birth to age 3, is required by law. Public law 94-142 was
Psychosocial Rehabilitation Program Services
Psychosocial Rehabilitation Program Services 2013 Overview Objectives Definitions What it is not What it is Who can provide What to focus on Populations of Service Documentation Requirements 2 Objectives
Early Intervention Services in New Jersey Frequently Asked Questions
Early Intervention Services in New Jersey Frequently Asked Questions What Should You Do If You Think an Infant or Toddler Is Not Growing or Developing as He or She Should? Seek help early. The first three
September 13, 2011 ASSEMBLY BILL 114: NONPUBLIC AGENCY CERTIFICATION
Page 1 September 13, 2011 Dear County and District Superintendents, Special Education Local Plan Area Directors, Special Education Administrators at County Offices of Education, Charter School Administrators,
MEDICAID AND SCHOOL HEALTH: A TECHNICAL ASSISTANCE GUIDE. August 1997
MEDICAID AND SCHOOL HEALTH: A TECHNICAL ASSISTANCE GUIDE August 1997 This guide contains specific technical information on the Medicaid requirements associated with seeking payment for coverable services
School-Based Services Department of Public Health and Human Services. Rena Steyaert Program Officer
School-Based Services Department of Public Health and Human Services Rena Steyaert Program Officer A View of Medicaid in Schools Schools have been able to provide and obtain reimbursement from Medicaid
School-based Support Personnel
L. SUPPORT SERVICES School-based Support Personnel Yukon Education provides both professional and paraprofessional support to schools to address the diverse learning of students. Learning Assistance Program
Henrico County Public Schools Department of Exceptional Education
Henrico County Public Schools Department of Exceptional Education EDUCATIONAL EVALUATION CRITERIA FOR CONSIDERATION OF PRIVATE EVALUATIONS Revised 06/12/2013 Professionals utilize educational evaluations
EPSDT HEALTH AND IDEA RELATED SERVICES
EPSDT HEALTH AND IDEA RELATED SERVICES Chapter Twenty of the Medicaid Services Manual Issued March 01, 2013 Claims/authorizations for dates of service on or after October 1, 2015 must use the applicable
To help improve the educational experience and general wellbeing of those students who are unable to profit from the existing school program.
LOCATOR: 3.01 TITLE: School Psychologist QUALIFICATIONS: 1. Valid Connecticut certification with endorsement as psychologist. 2. Such alternatives to the above qualifications as the Board may find appropriate
NEW YORK STATE MEDICAID PROGRAM HEARING AID/AUDIOLOGY MANUAL
NEW YORK STATE MEDICAID PROGRAM HEARING AID/AUDIOLOGY MANUAL POLICY GUIDELINES Table of Contents SECTION I - REQUIREMENTS FOR PARTICIPATION IN MEDICAID...2 SERVICES PROVIDED TO PATIENTS UNDER 21 YEARS
SCHOOL-BASED REHABILITATIVE AND RBHS SERVICE RATES (With Interim PRS Rates) Revised 4/16/15 Description Code Modifiers Reimbursement Rates AUDIOLOGY
Description Code Modifiers Reimbursement Units Rates AUDIOLOGY Frequency AUDIOLOGICAL EVALUATION 92557 None $40.80 One evaluation 1/12 months (Comprehensive Audiometry Threshold) AUDIOLOGICAL RE-EVALUATION
SPECIAL EDUCATION PLAN
SPECIAL EDUCATION STAFF People in several roles support the delivery of Services in TLDSB. These roles are filled by employees of the board, and by persons contracted to provide service in some areas.
Medical Policy Original Effective Date: 07-22-09 Revised Date: 01-27-16 Page 1 of 5
Disclaimer Medical Policy Page 1 of 5 Refer to the member s specific benefit plan and Schedule of Benefits to determine coverage. This may not be a benefit on all plans or the plan may have broader or
IOWA. State/Territory:
Attachment 3.1-A PAGE - 10- State/Territory: 9. Clinic services as defined in 42 CFR 440.90 and as further described in Section 4320 (Clinic Services) of the State Medicaid Manual are provided with additional/imitations
Disability Rights Ohio Frequently Asked Questions about Medicaid: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
50 West Broad Street, Suite 1400 Columbus, Ohio 43215-5923 Tel. 614-466-7264 local / 800-282-9181 in Ohio TTY 614-728-2553 / 800-858-3542 in Ohio Fax 800-644-1888 Web: disabilityrightsohio.org Disclaimer:
Medicaid School Based Services (SBS) Fee-for-Service Program
Bulletin Michigan Department of Community Health Distribution: School Based Services 04-01 Issued: March 1, 2004 Subject: New Codes and Revisions LPN Services Addition Effective: April 1, 2004 Programs
Medicaid Certified School Match Program Frequently Asked Questions
Medicaid Certified School Match Program Frequently Asked Questions 1. Medicaid defines small group therapy sessions to include at least two students. I understand that if the group session has three to
AN ACT RELATING TO HEALTH INSURANCE; AMENDING A SECTION OF THE NEW MEXICO INSURANCE CODE TO PROVIDE FOR FREEDOM OF CHOICE OF
AN ACT RELATING TO HEALTH INSURANCE; AMENDING A SECTION OF THE NEW MEXICO INSURANCE CODE TO PROVIDE FOR FREEDOM OF CHOICE OF HOSPITAL AND PRACTITIONER TO INCLUDE LICENSED PROFESSIONAL MENTAL HEALTH COUNSELORS
Adaptive Physical Education
Adaptive Physical Education Adapted Physical Education - APE Adapted physical education is a diverse program of developmental activities, exercises, games, rhythms, and sports designed to meet the unique
Clarification of Medicaid Coverage of Services to Children with Autism
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 CMCS Informational Bulletin DATE: July 7, 2014
Important Benefi ts for Medicaid Eligible Children: EPSDT EARLY & PERIODIC SCREENING DIAGNOSIS & TREATMENT. Ohio Legal Rights Service
Important Benefi ts for Medicaid Eligible Children: EPSDT EARLY & PERIODIC SCREENING DIAGNOSIS & TREATMENT Ohio Legal Rights Service On October 26, 2005, Ohio Legal Rights Service (OLRS) fi led a lawsuit
SHARS Billing Guidelines (Effective 9/1/06)
Updated December 1, 2007 SHARS Billing Guidelines (Effective 9/1/06) Psychological Services - Assessment Services Procedure Code: 96101 Psychological testing (includes psychodiagnostic assessment of personality,
Certified Staff Position (Job Description)
Certified Staff Position (Job Description) Title: Principal 1. Masters degree in Special Education or related area of specialization 2. Five years of successful teaching; counseling; supervisory or administrative
Basic and Enhanced Plan of Action in North TN
3.R ESSENTIAL PROVIDERS BASIC PLAN (For Low-Income Children and Working-Age Adults) The Basic Benchmark Benefit Package includes Clinic Services and Rehabilitative Services furnished by certain essential
CHAPTER 700 SCHOOL-BASED CLAIMING PROGRAM/DIRECT SERVICE CLAIMING 700 CHAPTER OVERVIEW... 700-1 710 MEDICAL AND FINANCIAL RECORDS...
700 CHAPTER OVERVIEW... 700-1 GENERAL REQUIREMENTS 700-1 REFERENCES. 700-3 710... 710-1 720 COVERED SERVICES... 720-1 A. AUDIOLOGY... 720-1 B. BEHAVIORAL HEALTH SERVICES... 720-2 BEHAVIORAL HEALTH PROVIDERS...
Administrative Code. Title 23: Medicaid Part 223
Title 23: Medicaid Administrative Code Title 23: Medicaid Part 223 Table of Contents Table of Contents Title 23: Medicaid... 1 Table of Contents... 1 Title 23: Division of Medicaid... 1 Part 223: Early
Diabetes Self-Management Training Services
INDIANA HEALTH COVERAGE PROGRAMS PROVIDER REFERENCE M ODULE Diabetes Self-Management Training Services L I B R A R Y R E F E R E N C E N U M B E R : P R O M O D 0 0 0 2 3 P U B L I S H E D : F E B R U
Occupational therapy Speech-language pathology (SLP)
2009 Medicaid Transformation Program Review Outpatient Therapy Services Description Rehabilitative therapy services are optional Medicaid services which include physical therapy, occupational therapy,
Lock in Your Team: The Role of the School Nurse in Special Education
Lock in Your Team: The Role of the School Nurse in Special Education 2009 National Alliance for Medicaid in Education Thursday, October 15, 10:45 AM 12:15 PM Derby Janet Lowe, LSN, CPN, MA Lock In : To
Reimbursement and Billing Information
Reimbursement and Billing Information Department of Behavioral Health and Developmental Services 1220 Bank Street Richmond, Virginia 23219 www.infantva.org Who can bill for early intervention services?
School Based Medicaid Claiming Program Snapshot
Occupational Therapy IEP; prescribed by a physician Registered by the American Occupational Therapy Association (now the NBCOT for certification purposes); or a graduate of a program in occupational therapy
ARLINGTON PUBLIC SCHOOLS SPECIAL EDUCATION PROGRAMS AND SERVICES
ARLINGTON PUBLIC SCHOOLS SPECIAL EDUCATION PROGRAMS AND SERVICES Introduction The Arlington Public Schools provides a comprehensive array of programs and services from pre-school through grades 12 designed
III. FREE APPROPRIATE PUBLIC EDUCATION (FAPE)
III. FREE APPROPRIATE PUBLIC EDUCATION (FAPE) Understanding what the law requires in terms of providing a free appropriate public education to students with disabilities is central to understanding the
NEW YORK STATE MEDICAID PROGRAM REHABILITATION SERVICES POLICY GUIDELINES
NEW YORK STATE MEDICAID PROGRAM REHABILITATION SERVICES POLICY GUIDELINES Version 2015-1 Page 1 of 11 Table of Contents SECTION I REQUIREMENTS FOR PARTICIPATION IN MEDICAID 3 QUALIFIED PRACTITIONERS. 3
Belmont Public Schools Special Education Programs
Belmont Public Schools Special Education Programs Preschool Program School: Belmont system wide Population Served: Special Education Students Aged 3 5 Grade: Pre K Program Description: This program is
NEW YORK STATE MEDICAID PROGRAM REHABILITATION SERVICES PROCEDURE CODES & FEE SCHEDULE
NEW YORK STATE MEDICAID PROGRAM REHABILITATION SERVICES PROCEDURE CODES & FEE SCHEDULE Table of Contents General Rules and Information... 3 Occupational Therapist, Physical Therapist and Speech Language
IDAPA 2/18/2015. School Based Medicaid Related Services. 16.03.09 School Based Medicaid 24.23.01 - SLP 24.06.01 OT 24.13.01 PT
School Based Medicaid Related Services Presenters: Shannon Dunstan, Department of Education Frede Trenkle, Department of Health and Welfare What will be presented: Implementation of School Based Medicaid
Special Educaton Staff
Special Educaton Staff The following consultant/support personnel provide service in addition to regular and special subject consultants, coordinators and guidance counselors. Please refer to Appendix
Habilitative Services Senate Bill 701
Habilitative Services Senate Bill 701 Who? The IFSP or IEP team must present the information to the family. When? Transition from ITP to preschool special education Initial IEP At least annually Upon the
Register of Students with Severe Disabilities
Department of Education Learners first, connected and inspired Register of Students with Severe Disabilities Department of Education Register of Students with Severe Disabilities 1. Eligibility Criteria
Florida Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Florida
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Florida As of July 2003 2,441,266 people were covered under Florida's Medicaid and SCHIP programs. There were 2,113,820 enrolled in the
State of California Health and Human Services Agency Department of Health Care Services
State of California Health and Human Services Agency Department of Health Care Services TOBY DOUGLAS DIRECTOR EDMUND G. BROWN JR. GOVERNOR DATE: All Plan Letter 14-xxx TO: ALL MEDI-CAL MANAGED CARE HEALTH
Individual Family Service Plan - A Review
Infants and Toddlers Program Provider Manual Provider 1 TABLE OF CONTENTS Chapter I. General Program Policies Chapter II. Member Eligibility Chapter IV. Billing Iowa Medicaid Appendix III. Provider-Specific
MEDICAID SERVICES MANUAL TRANSMITTAL LETTER CUSTODIANS OF MEDICAID SERVICES MANUAL TAMMY MOFFITT, CHIEF OF PROGRAM INTEGRITY
MEDICAID SERVICES MANUAL TRANSMITTAL LETTER October 19, 2015 TO: FROM: SUBJECT: CUSTODIANS OF MEDICAID SERVICES MANUAL TAMMY MOFFITT, CHIEF OF PROGRAM INTEGRITY MEDICAID SERVICES MANUAL CHANGES CHAPTER
Implantable Bone Conduction Clinical Coverage Policy No: 1A-36 Hearing Aids (BAHA) Amended Date: October 1, 2015.
Implantable Bone Conduction Clinical Coverage Policy No: 1A-36 Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 1.1 Conductive Hearing Loss... 1 1.2 Sensorineural Hearing Loss...
SECTION 2 TARGETED CASE MANAGEMENT FOR THE CHRONICALLY MENTALLY ILL. Table of Contents
SECTION 2 TARGETED CASE MANAGEMENT FOR THE CHRONICALLY MENTALLY ILL Table of Contents 1 GENERAL POLICY... 2 1-1 Authority... 2 1-2 Definitions... 2 1-3 Target Group... 2 1-4 Qualified Targeted Case Management
Position Description
Teacher As set by state certification authorities. Principal/Assistant Principal Teacher Assistants, Volunteers, Para-professionals, and college students assigned for clinical experience. To lead students
Ryan White Program Services Definitions
Ryan White Program Services Definitions CORE SERVICES Service categories: a. Outpatient/Ambulatory medical care (health services) is the provision of professional diagnostic and therapeutic services rendered
PROVIDER BULLETIN No. 05-05
PROVIDER BULLETIN No. 05-05 February 15, 2005 TO: FROM: BY: RE: Speech Therapy Providers Mary Steiner, Interim Administrator, Medicaid Division Marsha Rekart, Program Specialist Medicaid coverage of speech
EARLY INTERVENTION SERVICE DESCRIPTIONS, BILLING CODES AND RATES
EARLY INTERVENTION SERVICE DESCRIPTIONS, BILLING CODES AND RATES EARLY INTERVENTION PROVIDER HANDBOOK Illinois Department of Human Services Community Health and Prevention Bureau of Early Intervention
PART I DEPARTMENT OF PERSONNEL SERVICES 6.281 STATE OF HAWAII 6.286... 6.287 6.298 Class Specifications for the
PART I DEPARTMENT OF PERSONNEL SERVICES 6.281 STATE OF HAWAII 6.286................................................................ 6.287 6.298 Class Specifications for the Series Definition: OCCUPATIONAL
Medicaid School Based Services
Medicaid School Based Services An Educator s Guide to Fee for Service and Administrative Outreach Programs Newaygo County Regional Educational Service Agency Newaygo County Regional Educational Agency
NEW YORK STATE MEDICAID PROGRAM HEARING AID/ AUDIOLOGY SERVICES PROCEDURE CODES
NEW YORK STATE MEDICAID PROGRAM HEARING AID/ AUDIOLOGY SERVICES PROCEDURE CODES Table of Contents GENERAL INFORMATION AND INSTRUCTIONS----------------------------------------------- 2 A. DIAGNOSTIC SERVICES
PART I DEPARTMENT OF PERSONNEL SERVICES 6.347 STATE OF HAWAII 6.348... 6.349 6.350 Class Specification for the SPEECH PATHOLOGY SERIES
PART I DEPARTMENT OF PERSONNEL SERVICES 6.347 STATE OF HAWAII 6.348............................. 6.349 6.350 Class Specification for the SPEECH PATHOLOGY SERIES This series includes all classes of positions
HEAD START PERFORMANCE STANDARDS W/ MENTAL HEALTH FOCUS
HEAD START PERFORMANCE STANDARDS W/ MENTAL HEALTH FOCUS This list represents a variety of Head Start Performance Standards that include some aspect of mental health; however, it is not exhaustive of every
Subject: Health; health insurance; autism spectrum disorders. Statement of purpose: This bill proposes to require health insurers6
2010 Page 1 1 2 3 4 5 S.262 Introduced by Senators Carris and Campbell Referred to Committee on Finance Date: Janaury 5, 2010 Subject: Health; health insurance; autism spectrum disorders Statement of purpose:
Preparation "Speech Language Pathologist Overview"
Speech Language Pathologist Overview The Field - Preparation - Day in the Life - Earnings - Employment - Career Path Forecast - Professional Organizations The Field Speech-language pathologists, sometimes
POSITION: Speech Language Pathologist
Please note: This job description is one of several adopted by the State Board of Education between 1984 and 1987 and was designed to correspond with the evaluation instrument. Local school systems can
Career Paths for the CDS Major
College of Education COMMUNICATION DISORDERS AND SCIENCES (CDS) Advising Handout Career Paths for the CDS Major Speech Language Pathology Speech language pathologists work with individuals with communication
Paying for Early Childhood Intervention Services
Paying for Early Childhood Intervention Services eci early childhood intervention Department of Assistive and Rehabilitative Services Division for Early Childhood Intervention Table of Contents What is
Q: Is there an age limit on students who can be billed under the Program? A: Yes. The children billed must be under age 21.
Frequently Asked Questions for the New Massachusetts School Based Medicaid Claiming Program (Developed by MSB based on guidance in the new provider agreement) Q: Do School Districts in Massachusetts have
FREQUENTLY ASKED QUESTIONS REGARDING SCHOOL AUDIOLOGY SERVICES
FREQUENTLY ASKED QUESTIONS REGARDING SCHOOL AUDIOLOGY SERVICES The purpose of this document is to respond to questions concerning the role and responsibilities of educational audiologists and how they
District of Columbia Department of Health Care Finance Billing Changes for EPSDT
District of Columbia Department of Health Care Finance Billing Changes for EPSDT Effective October 1, 2014 Training Objective Identify and explain billing changes for the EPSDT program Agenda EPSDT Program
Your Anthem Blue Cross HMO Plan Amendment
Your Anthem Blue Cross HMO Plan Amendment Anthem Blue Cross ( Anthem ) agrees to modify your Combined Evidence of Coverage and Disclosure (Evidence of Coverage) Form by this amendment. All other provisions
Position Classification Standard for Speech Pathology and Audiology Series, GS-0665
Position Classification Standard for Speech Pathology and Audiology Series, GS-0665 Table of Contents SERIES DEFINITION... 2 EXCLUSIONS... 2 COVERAGE OF THE SERIES... 3 COVERAGE OF THE STANDARD... 4 OCCUPATIONAL
Be it enacted by the People of the State of Illinois,
AN ACT regarding disabled persons. Be it enacted by the People of the State of Illinois, represented in the General Assembly: Section 5. The State Employees Group Insurance Act of 1971 is amended by changing
15 HB 429/AP A BILL TO BE ENTITLED AN ACT
House Bill 429 (AS PASSED HOUSE AND SENATE) By: Representatives Stephens of the 164 th, Wilkinson of the 52 nd, Shaw of the 176 th, Dollar of the 45 th, Rogers of the 29 th, and others A BILL TO BE ENTITLED
The Field of Counseling
Gainful Employment Information The Field of Counseling Job Outlook Veterans Administration one of the most honorable places to practice counseling is with the VA. Over recent years, the Veteran s Administration
STATE OF NEBRASKA STATUTES RELATING TO AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY PRACTICE ACT
2009 STATE OF NEBRASKA STATUTES RELATING TO AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY PRACTICE ACT Department of Health and Human Services Division of Public Health Licensure Unit 301 Centennial Mall South,
SECTION 2. School-Based Skills Development Services. Table of Contents
Division of Medicaid and Health Financing Updated October 2014 SECTION 2 Table of Contents 1 SERVICES... 2 1-1 Authority... 2 1-2 Definitions... 2 1-3 Target Group... 4 1 4 Provider Qualifications... 4
Local Education Agency
KANSAS MEDICAL ASSISTANCE PROGRAM PROVIDER MANUAL Local Education Agency PART II Introduction Section Page 7000 Local Education Agency Billing Instructions............ 7-1 7010 Local Education Agency Billing
OREGON HEALTH CARE CAREERS
Career School Degree Required Description Art Therapy Marylhurst Masters Art therapists use drawings and other art/media forms to assess, treat, and rehabilitate patients with mental, emotional, physical,
The Healthy Michigan Plan Handbook
The Healthy Michigan Plan Handbook Introduction The Healthy Michigan Plan is a health care program through the Michigan Department of Community Health (MDCH). Eligibility for this program will be determined
School Supportive Health Services Program Preschool Supportive Health Services Program. Questions and Answers Issued June 11, 2010
School Supportive Health Services Program Preschool Supportive Health Services Program Questions and Answers Issued June 11, 2010 Status of School and Preschool Supportive Health Services Program 1. Q.
NEW YORK STATE MEDICAID PROGRAM HEARING AID/ AUDIOLOGY SERVICES FEE SCHEDULE
NEW YORK STATE MEDICAID PROGRAM HEARING AID/ AUDIOLOGY SERVICES FEE SCHEDULE Table of Contents GENERAL INFORMATION AND INSTRUCTIONS----------------------------------------------- 2 CODES -------------------------------------------------------------------------------------------------------
Florida Medicaid and Implementation of SB 2654
Florida Medicaid and Implementation of SB 2654 Shachi Mankodi Counsel to the Chief of Staff Florida Agency for Health Care Administration Autism Compact Presentation September 18, 2008 Overview What is