May 2003 Memo on Medicaid Billing for Day Treatment Centers


Date: May  23, 2003

To: Superintendents of Public School Districts and Approved Day Treatment Centers

From: Robert J. Scalise, Coordinator

Medicaid Services Unit

Subject: Medicaid claiming for Health Related Support Services - Counseling Services at Day Treatment Centers.

School districts in New York State may claim Medicaid reimbursement for health related support services provided to Medicaid-eligible students with disabilities and indicated on an Individualized Education Program (IEP) under the School Supportive Health Services Program (SSHSP).  The health related services eligible for Medicaid claiming are Speech, Physical Therapy, Occupational Therapy, Counseling and Skilled Nursing Services.  Documentation requirements under the SSHSP are available through the Medicaid Guidebook located on the Medicaid Web Page at:

School districts place students with disabilities in approved Day Treatment Centers.  Students placed in Day Treatment require extensive mental health services, i.e. counseling services, which are reimbursed by Medicaid directly to the Day Treatment Center.  School districts should not claim Medicaid for counseling services indicated on a students IEP, the Day Treatment Center will claim Medicaid directly for the counseling service.

The Day Treatment Center, however, does not claim Medicaid for the other eligible health related services indicated on the IEP.  The school district may claim Medicaid reimbursement for Speech, Physical Therapy, Occupational Therapy and Skilled Nursing Services indicated on the IEP under the SSHSP.  In addition the school district may claim Medicaid reimbursement for any corresponding evaluations as well as any TCM reviews provided the student if the following steps are in place:

  • School Districts must request that the Day Treatment Center complete a Provider Agreement and a Statement of Reassignment (attached).  These forms signed by the Day Treatment Center attest that the Day Treatment Center will not claim Medicaid for the Medicaid eligible services claimed by the school district under the SSHSP.   In addition, the Day Treatment Center would attest that all the health related support services indicated on the IEP are provided in accordance with Medicaid regulations.

  • School districts must request that the Day Treatment Center document the delivery of service signed by the service provider monthly.  The school district must provide the form used to document these services (attached).  In addition, Part 200 of the regulations of the Commissioner require Progress Notes be provided to parents at the same frequency Progress Notes are provided to the parents of non-disabled students.  The school district must indicate the frequency with which these progress notes are required.  The form used to document the monthly delivery of service allows for a progress notation.  Finally, the appropriate credential required for service providers are indicated in the Medicaid Guidebook available at the Medicaid WEB page, address above.

If you have any questions regarding the information above you may contact me at my email address: or at 518: 474-9341.  Thank you for your cooperation in this matter.

cc:Theresa Savo

Thomas Hamel

Michael Albino

Last Updated: April 24, 2009