Issue #10-01

We have been notified that the New York State SPA #09-61 for the Preschool/School Supportive Health Services (SSHS) Program was approved on April 26, 2010 by the Centers for Medicare and Medicaid Services (CMS). This SPA requires a new reimbursement methodology, clarifies provider qualifications and documentation requirements for SSHS and allows SSHS enrolled school districts, §4201 schools and counties to claim Medicaid reimbursement for the following services:

• Physical Therapy Services
• Psychological Evaluations
• Occupational Therapy Services 
• Medical Evaluations
• Speech Therapy Services 
• Medical Specialist Evaluations
• Psychological Counseling Services 
• Audiological Evaluations
• Skilled Nursing Services
• Special Transportation

Medicaid billings for these services provided on or after September 1, 2009 will resume once the necessary changes are in place and providers have met all requirements for compliance with the new SPA.  Further information on this will be forthcoming.

NYSED and NYS OHIP, along with your local Regional Information Center (RIC), will be conducting required regional trainings concerning the policy and reimbursement changes associated with the State Plan Amendment and Compliance Agreement.

Please see the NYSED Medicaid in Education website for a copy of the SPA #09-61. If you have any questions or comments regarding this alert, please contact your local RIC representative or the NYS Education Department, Medicaid Unit.