Special Billing Instructions for Supplies and Equipment
Supplies and equipment can be billed under the “Medicaid to Schools” Program, as discussed below. The following types of supplies and equipment are covered:
- Occupational Therapy
- Physical Therapy
- Vision Services
Supplies and equipment related to evaluation, diagnosis and treatment of speech/ language and hearing disorders which result in communication disabilities, and supplies and equipment related to the provision of occupational therapy (OT) or physical therapy (PT) must be provided by or under the supervision of a qualified professional.
Vision includes those supplies and equipment that relate to the following:
- Restoration of vision and/or related functioning to the best possible functional level
- Aids to vision prescribed by an ophthalmologist or optometrist
- Diagnostic screening and prevention of visual disorders
Nursing supplies and equipment that are billable are those related to any evaluations, treatments or consultations performed by a licensed nurse in order for the child to benefit from an educational program under the “Medicaid to Schools” rules.
In order to bill for supplies and equipment, MSB™ needs ALL of the following documentation:
- Copy of IEP page documenting need for equipment
- Referral, order or prescription as indicated below:
- For Speech/Language/Hearing: Referral from physician or licensed practitioner of the healing arts, documenting need for equipment related to disorder
- For Occupational Therapy or Physical Therapy: Order from physician or licensed practitioner of the healing arts
- For Vision: Prescription from ophthalmologist or optometrist
- For Nursing: Statement that the items have been determined by a licensed nurse to be necessary and appropriate
- Statement from the school district that equipment and supplies are considered the personal property of the student
- Copy of the paid invoices
Recall that the district will be reimbursed at 50% of allowable cost, up to the Medicaid cap, assuming the above requirements are met. Supply and equipment claims must be submitted within one year of the date of the paid invoice, so the district must provide all of the required information to MSB™ as soon as possible after it pays for the supplies and equipment.