Medicaid in Education Alert
New York State Department of Health (DOH), Office of Health Insurance Programs (OHIP)
New York State Education Department (NYSED)
Preschool/School Supportive Health Services Program (SSHSP)
Medicaid in Education

Issue #24-07

To: All SSHSP Medicaid Providers
From: NYS DOH OHIP SSHSP &
NYSED Medicaid in Education Unit
Date: October 9, 2024
Subject: Effective Immediately – Temporary pause on submitting Medicaid  claims for physical, occupational and speech therapy to eMedNY

Effective Immediately SSHSP providers are to hold their Medicaid claims for physical, occupational and speech therapy until further notice. It has come to our attention that an eMedNY problem is causing many SSHSP Medicaid claims to be wrongly denied. Providers may see denials related to suspected duplicate claiming, therapy procedure code modifiers, and prior authorization. While the Department of Health is working on correcting the problem providers should hold their Medicaid claims for physical, occupational and speech therapy to eMedNY until further notice. We hope that this will be fixed by December 1 and will issue another Medicaid Alert to update you on this as soon as we can.

If you have any questions or comments regarding this alert, please contact the NYS Department of Health at (518) 473-2160 or at SSHSP@health.ny.gov, the NYS Education Department, Medicaid Unit at medined@nysed.gov.

Last Updated: October 9, 2024