Medicaid

Sample Medicaid Documentation is located on Samples|Forms|Notifications

NYSED Memos related to 1:1 Nursing In School are located on Laws|Guidelines|Memos School Nurse|Nursing Tasks

If you have any questions or comments regarding this handbook, please contact your local Regional Technical Support representative 9 am to 4 pm weekdays or email the NYS Education Department, Medicaid Unit at medined@nysed.gov. (2/9/18)

NYS Medicaid in Education Website

 Alerts and Memo By Release Date

Additional alerts on NPI numbers, provider enrollment in SSHSP, school Medicaid billing, training, ICD-10, etc. can be found on the Medicaid website: www.oms.nysed.gov/medicaid/medicaid_alerts/

Guidelines and Policies

NYSED Medicaid Private Duty Nursing Manual Prior Approval Guidelines. This guidance outlines Medicaid reimbursement for skilled nursing services during school hours. (1/2019)  

NYSED Medicaid Private Duty Nurse Manual Policy Guideline. This guidance provides information on the requirements for participation in Medicaid. (1/2019)

 

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 (Update 9) was developed by the NYS Department of Health in conjunction with the NYS Department of Education. This handbook should replace any guidebook you are currently using.  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. Handbook revisions are noted on pp. 82-83. (3/2018).

 

Monthly Medication Administration Record - MAR- A sample MAR is on page 31 of the SSHSP Medicaid in Education Billing Handbook. (3/2018)

Additional NYSCSH sample resource documentation for catheterization care, gastrostomy feeding, and tracheostomy suctioning are available on the Samples|Forms|Notifications page

Pre-school/School Supportive Health Services Program(SSHSP) Medicaid in-Education Q & A 

Medicaid Q and A page. Questions 1-227 were updated 12/9/16. Questions 60 - 70 address Skilled Nursing Services including information on the NPI number. (12/16/16)

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 (NYSCSH 12-1-11)

National Alliance for Medicaid in Education, Inc. (NAME) is a non-profit organization of school districts and state Medicaid and Education agencies who share information.on Medicaid claiming for public schools which may allow schools to recover some of their costs for serving Medicaid-eligible school-age children.

Updated 9/5/19