TO: All SSHSP Medicaid Providers
FROM: NYS OHIP SSHSP & NYSED
Medicaid in Education Units
DATE: August 25, 2010
New York State Plan Amendment (SPA) #09-61 for the Preschool/School Supportive Health Services Program (SSHSP) was approved on April 26, 2010 by the Centers for Medicare and Medicaid Services (CMS), retroactive to September 1, 2009. SPA #09-61 indicates that in order to be Medicaid reimbursable, occupational therapy services must be provided by:
· A New York State licensed and currently registered occupational therapist qualified in accordance with the requirements of 42CFR §440.110(b) and with applicable state and federal law and regulations, acting within his or her scope of practice under New York State law; or
· A certified occupational therapy assistant (COTA) “under the direction of” such a qualified licensed and registered occupational therapist, acting within his or her scope of practice under New York State Law.
Occupational therapy assistants providing school supportive health services must be certified by the New York State (NYS) Education Department. State Education Law Article 156 §7906(6) requires occupational therapy assistants to be certified by the Commissioner of Education as having successfully completed a program for occupational therapy assistants in accordance with the commissioner’s regulations. An occupational therapy assistant (OTA), certified by the NYS Education Department, may only work under the direction of an occupational therapist who has a NYS license and current NYS registration. Refer to School Supportive Health Services guidance (Questions and Answers) at http://www.oms.nysed.gov/medicaid/q_and_a/ for additional information about “under the direction of” requirements.
Occupational therapy assistants may also be registered with
the National Board for Certification of Occupational Therapy (NBCOT); however,
this is not required for Medicaid reimbursement purposes. Occupational therapy assistants who are
If you have any questions or comments regarding this alert, please contact your local Regional Information Center representative or the NYS Education Department, Medicaid Unit at firstname.lastname@example.org.