Certified Public Expenditures (CPEs)
School Supportive Health Services Program
Preschool Supportive Health Services Program
Certified Public Expenditures (CPEs)
Federal Medicaid law and regulation authorize the use of Certified Public
Expenditures (CPEs), an annual cost reconciled and settled reimbursement
methodology. The CPE methodology allows NYS
to request additional federal funding for SSHSP costs that are
not completely covered by current Medicaid reimbursement. DOH has contracted
with Public Consulting Group, Inc. (PCG) to implement and support
the additional reimbursement methodology.
School districts and counties billing for Medicaid services under the SSHSP are required to participate in an annual cost reporting process. The components of CPEs include a Random Moment Time Study (RMTS) and a Cost Based Settlement Process.
State Plan Amendment (SPA) 11-39-A and 11-39-B have been approved by the Centers for Medicare and Medicaid Services (CMS). These SPA's are located under Resources, along with SPA 09-61 (encountered based billing).
Random Moment Time Study (RMTS)
Manual 
(1 MB) (posted 9/2/14)
The RMTS Coordinator Manual details how to navigate the new RMTS system and certify the district staff pool list, as well as updating and certifying the district calendar.
NY SSHSP Medicaid Cost Based Settlement Process
Manual (960 KB) (UPDATED-posted 11/20/17)
The Manual to Cost Reporting for the SSHS Direct Service Claiming Program guides you thru the web-based software application that demonstrates the school districts and counties cost of providing IEP services to Medicaid-eligible students. The school district and county business office is responsible for completing the annual cost report.
Medicaid Alert 17-04 (HTML) (18 KB) (posted 10/30/17)
Certified Public Expenditure (CPE) Cost Report Training
CMS Approved Direct Medical Services Materials (16 KB) (posted 9/11/12)
Cost Reporting Update - Service Encounters (418 KB) (posted 5/21/15)
Medicaid Alert 16-07 (104 KB) (posted 11/8/16)
IEP Ratio Methodology and Reporting Updates
Medicaid Administrative Claiming (MAC)
Medicaid Alert 13-13 (18 KB) (posted 11/7/13)
Suspension of Medicaid Administrative Claiming (MAC) RMTS
Medicaid Alert 13-01 (184
KB) (posted 2/6/13)
Medicaid Administrative Claiming
Presentation 
(2.22 MB) (posted 2/5/13)
Currently, school districts and counties only receive Medicaid reimbursement
for direct services based on a fee for service model with an annual cost
settlement process. The MAC program is a reimbursement process for claiming the costs of administrative
and outreach activities that support the Medicaid program.
Additional Resources
Medicaid Alert 19-04 (HTML) (92.1 KB) (posted 9/4/19)
Random Moment Time Study (RMTS) to Resume 10/1/19 For the Rest of State (ROS)
2018 CPE Training Materials Download (6,791 KB) (posted 12/28/18)
This zip file contains the following resources prepared by PCG for CPE and RMTS training provided to SSHSP billing providers during fall 2018:
- NY SSHSP Coordinator Manual 2018 (PDF)
- NY SSHSP Coordinator Training (PPT)
- NY SSHSP Participant Training (PPT)
- NYDOH SSHSP Cost Reporting Guide (PDF)
- Winter 2018 NYSSHSP Cost Report Training (PDF)
Presentation (237 KB) (posted 12/5/14)
DOH/PCG Presentation to NYS Association of School Business Officials, December 5, 2014
Medicaid Alert 13-11 (68 KB) (posted 11/7/13)
SSHSP Cost Report - Establishment of the IEP Ratio
Attachment 1 - IEP Ratio Uploading Instructions
Public Consulting Group, Inc. Contact Information
Hotline: 866-912-2974
E-mail: NYSSHSP@pcgus.com