FAQ's

Frequently asked questions . . .

How long does it take to complete an IEP Service Coordination form? Student demographics, Case Manager & school will usually be pre-printed on the form. It should take less than 5 minutes to complete.

Who can submit IEP Service Coordination forms?  In order to submit billing for IEP coordination services, the service provider must be: 
A professional who has a current license or certification in accordance with COMAR 10.09.52.03(C)(2)(3). 

o    Audiologist, registered nurse, occupational therapist, physical therapist, social worker, or speech-language pathologist licensed in the State of Maryland; OR

o    Guidance counselor, pupil personnel worker, speech-language pathologist, psychologist with at least a master's degree; OR

o     An educator with a MSDE issued teaching certificate (Advanced Professional Certificate, Standard Professional Certificate or a Conditional 2-year Certificate).  

Other non-professionals may also serve as a service coordinator under COMAR 10.09.52.03(C)(2)(4) but with restrictions.    

What types of case management services are eligible for Medicaid reimbursement?  Service Coordination is defined as "case management services" that assist students in gaining access to the services recommended in his/her IEP. The case manager will monitor the delivery of the student's goals and objectives and ensure that they meet the student's current needs. Billable services include:

·         Development of the initial IEP, including evaluations ordered by the IEP Team

·         Annual Review/IEP Team Meetings

·         Monthly Service Coordination such as communication with parent and quarterly/monthly progress notes related to IEP goals.

Can incentive funds be utilized for items in departments or programs other than Special Education? No, incentive funds can only be used for items and equipment that expands or enhances the services provided to students with special needs. The federal government and MSDE/DHMH conduct audits on how Medicaid funds are utilized; therefore, funds should only be used as specified.

What is specialized transportation? PGCPS can bill Medicaid for students that need special accommodations when riding the school bus. Special accommodations such as but not limited to: student that requires a ramp or a lift; student that requires the aide's assistance in the vehicle; and when a student has behavior problems that preclude the student from riding a standard school bus. Case Managers bill Medicaid for case management services for the students that receive specialized transportation. The case management service is relegated to face-to-face contact with the student on a day when the student has received a covered school-based service that is identified in the student's IEP (such as speech or OT/PT services).

What happens if there are extenuating circumstances that prevent IEP Service Coordination forms from being completed (e.g., A per diem or long term substitute teacher replaces a teacher that has resigned, or is on maternity or sick leave)? Medicaid Coordinators should clearly note the circumstances, return the incomplete IEP coordination forms to our office, and our data technician will give credit to your school for returning the forms and it will not reflect negatively on your school's performance.

How does the Medicaid Recovery Office track school performance?  Each month, the Medicaid Recovery Office tracks the IEP Service Coordination forms sent out to each school and returned to us for processing.  A Principal's Report which shows the number of missing forms is distributed to the Principal as well as the Medicaid Coordinator around the 26th of each month.

How does the Medicaid Recovery Office communicate changes/modifications in the policies or process to special education staff?  Changes to Medicaid regulations during the school year will be directed to Principals and Medicaid Coordinators via email from your school's liaison. Our website is also a great source for any changes in Medicaid regulations and procedures.



Medicaid Recovery Office
Sasscer Administration Building
14201 School Lane - Trlr C05-451
Upper Marlboro, MD  20772

Phone: 301-952-6349 

***  B U L L E T I N  *** Click below to reach the MeduClaim Billing site!

CCLink

Maryland Medicaid and You.  
This report reflects on Medicaid’s
current footprint in Maryland and
offers opportunity for innovation

Last modified: 9/17/2013 3:35:42 PM