What guidance is offered for billing Medicaid for school-based services?
Schools can only bill for “medically related services” that are outlined in the State Medicaid Plan, however, a lack of guidance and confusion over policies for obtaining Medicaid payments for school-based services has created problems. The Centers for Medicare and Medicaid Services (CMS) has not provided adequate direction to states concerning Medicaid reimbursement for school services, according to recent reports by the U.S. General Accounting Office (GAO). GAO recommends that CMS develop technical guidance (not regulations) to states regarding Medicaid payments for school-based services, including the need for CMS to distinguish between school-based services that are primarily medical versus those that are educational. ASHA maintains that any distinction on medical versus educational speech-language pathology and audiology services is artificial, given that these services frequently correct or ameliorate communication disorders affecting a person’s health and education status simult
