MEDICAID SCHOOL-BASED ADMINISTRATIVE CLAIMING …

MEDICAID SCHOOL-BASED . ADMINISTRATIVE CLAIMING guide . May 2003. MEDICAID SCHOOL-BASED . ADMINISTRATIVE CLAIMING guide . TABLE OF CONTENTS. I. II. MEDICAID IN THE school III. INTERAGENCY A. GENERAL ..5. B. ELEMENTS OF THE INTERAGENCY AGREEMENT ..6. IV. PRINCIPLES OF ADMINISTRATIVE CLAIMING ..7. A. GENERAL ..7. B. OPERATIONAL PRINCIPLES ..7. 1. Proper and Efficient Administration ..7. 2. Capture 100 Percent of Time ..8. 3. Parallel Coding Structure: MEDICAID and Non- MEDICAID Codes for Each 4. Duplicate Payments ..9. 5. Coordination of 6. Performing Direct Services v. ADMINISTRATIVE a. Case Management as 11. b. Case Management as a Service .. 12. 7. Allocable Share of 8. Enhanced FFP Rates ..14. a. Skilled Professional Medical Personnel (SPMP) SCHOOL-BASED ADMINISTRATIVE 14. b. CLAIMING for Administration of Family Planning Services .. 16. 9. Provider Participation in the MEDICAID Program ..16. 10. Individualized Education Program (IEP) 11. Review and Approval of Program and Codes by CMS.

MEDICAID SCHOOL-BASED ADMINISTRATIVE CLAIMING GUIDE I. INTRODUCTION The school setting provides a unique opportunity to enroll eligible children in the Medicaid program,

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