Medicaid requires specific billing forms. The current official billing forms are included along with billing modules and sample billing forms. These forms cannot be altered except for entering student demographics.
Billable Services at Consent
Word document versions of billing forms are only to be used to enter and save student demographics at the top of the billing forms. The form content MUST NOT be altered.
- School-Based Nursing Services (PDF), (Word)
- School-Based Speech Therapy (PDF), (Word)
- School-Based Audiological Services (PDF), (Word)
- School-Based Psychological Services (PDF), (Word)
- School-Based Personal Care Medicaid Log (PDF), (Word)
- School-Based Physical Therapy (PDF), (Word)
- School-Based Occupational Therapy (PDF), (Word)
- Targeted Case Management Electronic Version (Word)
- Targeted Case Management (Speech Therapists Only – Word)
- Transportation (PDF), (Word)
Billing Modules
- Audiological Billing Module
- Nursing Billing Module
- Occupational Therapy Billing Module
- Personal Care Billing Module
- Targeted Case Management Billing Module
- Transportation Billing Module
- Physical Therapy Billing Module
- Speech Billing Module
- Psychological Services Billing Module
- Medicaid Update Training
Webinars
- Medicaid Webinar
- SBH Audit Process Power Point
- SBH Evaluation Tool Revision 9.1.19
- SBH Nursing Services Power Point
- SBH Occupational and Physical Therapy Services Power Point
- SBH Personal Care Services Power Point
- SBH Psychological Services Power Point
- SBH Speech Therapy Power Point
- SBH Targeted Case Management Services Power Point
- SBH Transportation Services Power Point