Medicaid

NYSED Resources

NYS Medicaid in Education Website

NYSED Medicaid Alerts
Alerts and Memo By Release Date. Along with alerts on NPI numbers, provider enrollment in SSHSP, school Medicaid billing, training, ICD-10, etc

Guidelines and Policies

NYSED Medicaid Private Duty Nursing Manual Prior Approval Guidelines
This guidance outlines Medicaid reimbursement for skilled nursing services during school hours.  

NYSED Medicaid Private Duty Nurse Manual Policy Guideline
This guide provides information on the requirements for participation in Medicaid.

Pre-school/School Supportive Health Services Program(SSHSP) Medicaid In-Education Provider Policy and Billing Handbook Update 9
The Preschool/School Supportive Health Services Program Handbook was developed by the NYS Department of Health in conjunction with the NYS Department of Education. This handbook, along with the Questions & Answers, provides a step-by-step outline of the procedures that must be followed when claiming Medicaid reimbursement. Any changes that occur after the release of this version will be posted on this site with effective dates for implementation. Section 6 discusses skilled nursing services. 

If you have any questions or comments regarding the above handbook, please contact your local Regional Technical Support representative from 9 am to 4 pm on weekdays or email the NYS Education Department, Medicaid Unit at medined@nysed.gov.

Monthly Medication Administration Record - MAR - - A sample MAR is on page 31 of the SSHSP Medicaid in Education Billing Handbook linked here.

Pre-school/School Supportive Health Services Program (SSHSP) Medicaid in-Education Q & A
Medicaid Q & A page. Questions 60 - 70 address Skilled Nursing Services, including information on the NPI number.

Additional Resources

eMedNY
Contains a list of Medicaid reimbursable drugs. Only prescription and non-prescription drugs which appear on this list are reimbursable under the fee-for-service Medicaid Pharmacy Program. 

How to Obtain your NPI Number

National Alliance for Medicaid in Education, Inc. (NAME)
Non-profit organization of school districts and state Medicaid and Education agencies that shares information on Medicaid claims for public schools, which may allow schools to recover some of their costs for serving Medicaid-eligible school-age children. 

See also:

Page Updated 8/18/22