Medicaid
regulations state that in order for Speech Services to
be reimbursable, they must be provided by a licensed
and/or ASHA (American Speech and Hearing Association)
certified speech pathologist. At the same time,
SED states that speech services must be provided by a
teacher of the speech and hearing handicapped.
Therefore, only those speech services provided by a
professional who is dually certified as a teacher of the
speech and hearing handicapped AND is a NYS licensed
and/or ASHA certified speech pathologist are
reimbursable through Medicaid.
"Under the direction of" for speech services
allows school districts to be reimbursed by Medicaid for
those services provided to Medicaid eligible students by
teachers of the speech and hearing handicapped. |
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"Under
the Direction of" for Speech Services Options for
Districts
Three options are currently offered to school districts
considering purchasing "Under the Direction
of" for speech services program. These currently
include: |
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a. |
Identify
Medicaid Eligible Students Receiving Speech Services
This option is delivered and billed on a ½ day per
quarter per therapist caseload. If a district has four
therapists, for example, they would contract for ½ day
per quarter per therapist for a total of 8 days for the
school year. Only those students identified by the
district will be reviewed. The district runs some risk
acquiring services delivered in this manner since
Medicaid eligibility for speech caseloads frequently
fluctuates, i.e., a student may be eligible for one
quarter and not the next or a student may not be
eligible for the first quarter but becomes eligible the
next quarter but is not being reviewed by the speech
pathologist since he/she was not identified to the
speech pathologist by the district.
Therefore, Medicaid lists should be reviewed by the
district on a regular basis to insure accuracy. |
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b. |
Review
of Total Caseloads
This option is delivered and billed on a full day per
therapist caseload. For example, a district with three
therapists choosing not to identify Medicaid eligible
students would contract for a total of 12 days for the
school year. |
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c. |
BOCES
Caseloads
If a district chooses, it may include their students
enrolled in BOCES programs for review by the Speech
Pathologist. If this is chosen, the BOCES caseload is
generally considered as an additional therapist (even
though in actuality many therapists may be involved).
For example, a district with four district therapists,
who also chooses to include their students enrolled in
BOCES programs, would be considered as having five
caseloads for review. |
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Request
for Service
To request this service, a letter must be sent to the
Assistant Principal of Special Education, Kathleen
Fonda, at the Special Education Center. |
