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SOESD / Special Education / Medicaid Billing / Claiming Codes

Medicaid Administrative Claiming Codes

Examples of activities by survey participants that can result in significant money to the district:

 
Code B1:
Medicaid/OHP Outreach and Facilitating Medicaid/OHP Eligibility

This code should be used when performing activities that inform eligible or potentially eligible individuals about Medicaid/OHP. This code should also be used when describing the range of services covered under Medicaid/OHP, how to access and obtain them, and the benefits of Medicaid/OHP prevention services. This code can be used when discussing Medicaid/OHP with students, parents or their guardians. Use this code when assisting an individual in applying for and becoming eligible for Medicaid/OHP. This includes consultation, written or verbal information, related paperwork, clerical activities or staff travel required to perform these activities.
 
Code C1:
Referral, coordination, monitoring and training of Medicaid/OHP services

This code should be used when making referral for, coordinating and/or monitoring the delivery of medical (Medicaid/OHP covered) services. This code may also be used when coordinating or participating in training or events and seminars for outreach staff regarding the benefits of the Medicaid/OHP program, how to assist families to access Medicaid/OHP services, and how to more effectively refer the student for services. Include related paperwork, clerical activities, or staff travel necessary to perform these activities.
 
Code D1:
Medicaid/OHP transportation and translation

This code should be used when assisting students obtain transportation to services covered by OHP, or when arranging for or providing translation services to facilitate access to OHP services. Includes related paperwork, clerical activities or staff travel required to perform these activities.
 
Code E1:
Program planning, policy development, and interagency coordination related to non-medical services

This code should be used when performing activities associated with the development of strategies to improve the coordination and delivery of Medicaid/OHP coverable medical/dental/mental health services to school age children. Includes related paperwork, clerical activities of staff travel required to perform these activities.



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