New York State Office of the Medicaid Inspector General (NYS OMIG)
School/Preschool Supportive Health Services Program (SSHSP/PSHSP)
Medicaid in Education Unit
Issue #08-4
TO: All SSHSP/PSHSP Medicaid Providers
FROM: NYS OMIG SSHSP/PSHSP Medicaid in Education Unit
DATE: February 28, 2008
SUBJECT: Speech Therapy – “Under the Direct Supervision of”
Clarification
CMS guidelines governing the supervision of each beneficiary’s care requires that a New York State licensed and registered Speech Language Pathologist (SLP) must see the beneficiary at the beginning of, and periodically during treatment.
No services provided by the Teacher of the Speech and Hearing Handicapped (TSHH) before the first meeting between the qualified SLP and the child are reimbursable by Medicaid. Also, transportation to these services would not be reimbursable.
Schools and Preschool providers should clearly document the first meeting between the qualified SLP and the child to establish the beginning of the Medicaid reimbursable period.
The CMS guidelines apply to all unpaid claims, regardless of the date of service.
For any questions/comments regarding this alert, please contact your Regional Information Center representative, NYS Education Department Medicaid Coordinators, or NYS OMIG Medicaid in Education Unit staff.