School-Based Medicaid Billing Software for Pennsylvania

Key facts about school-based Medicaid that Pennsylvania districts need to know, from covered services to billing rules. Relay's Medicaid billing software helps you manage your Medicaid program, from documentation to reimbursement.

Pennsylvania
School-Based Medicaid Billing Software for Pennsylvania
School-Based Medicaid Billing Software for Pennsylvania

Pennsylvania School Medicaid Coverage

  • Assistive Technology Devices
  • Audiology
  • Hearing-impaired Services
  • Nursing Services
  • Nurse Practitioner Services
  • Occupational Therapy
  • Physical Therapy
  • Speech Therapy
  • Orientation, Mobility & Vision
  • Personal Care Services
  • Physician Services
  • Psychiatric Services
  • Psychological Services
  • Social Work Services
  • Special Transportation

Eligibility & Billing in Pennsylvania

Eligibility defined as Medicaid-enrolled children under age 21 when the services are documented in the child’s IEP. To be eligible, children must also meet one of the listed IDEA categories and be MA-eligible on the date of service. The billing providers are the Local Education Agencies (LEAs), charter schools, intermediate units, vocational-technical schools, and preschool early intervention programs. Rendering providers must enroll in Medicaid.

What's Needed in Pennsylvania

Supervision Signoff
Yes
Modifiers on Procedure Codes
Yes
Prescriptions Needed
Yes
Telehealth
Yes
Free Care Expansion
Note
Not yet taken action on Medicaid expansion in schools.
*This should not be taken as state guidance and please refer to your state manual for the most updated guidance and regulations.

Equip Your Special Services Team

Documenting, claiming, and reimbursing for Medicaid in school districts is complex and evolves quickly. These resources will equip your team with the resources they need to simplify special services and recoup the Medicaid revenue they've earned.

Bring Relay to Your State

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