SOESD / Special Education / Medicaid Billing / FAQs
Frequently Asked Questions
What if I spent only a portion of a 15-minute increment on Medicaid-claimable work? Is that portion claimable?
That depends on the portion of time. If 8 minutes or more, then yes. The claimed portion must be the greater part of the increment to be claimed.
Related to the question above, what if I spent 5 minutes of claimable work with a student and then another 5 minutes with the same student later in the day? Can those two contacts be reported as a single increment?
No. Increments can only be coded for your activity in a single 15-minute increment. Whatever activity represents the majority (8 minutes at least) of your time in a single increment is what you code.
What if I am absent on a survey day? Do I still complete the online Time Study form?
Yes. Even if you are absent, your time must still be coded as "A" for regular time. If you cannot go online because of illness or any other leave, the MAC coordinator can code your time for you.
How long does a survey participant have before logging in and completing the survey?
DHS has told us that forms must be completed within five days, including the survey date. But it is always to your benefit to complete the survey as soon as possible to get a more accurate accounting of your time.
The hours of the Medicaid Time Study start at 7 a.m. and end at 8 p.m. How do I account for claimable activities that may take place between 8 p.m. and 7 a.m.?
Activities outside of these hours that might be claimable are ignored.
Why are the four claimable codes, B1, C1, D1, and E1 broken down in "sub codes"?
The use of sub codes such as C1.4 (training activities) is done to separate activities into smaller units of definition. The time study seeks to account for various aspects of your work shift, and the sub codes define more specifically what you were doing.
What about driving a student to the hospital for emergency medical care—is this claimable?
The driving activity itself is not claimable. However, the time spent arranging the transportation is claimable. The code for coordinating and arranging transportation to a Medicaid provider is "D1.1."
We want to include custodians and bus drivers in the participant pool. Can we? Schools sometimes say that these personnel have a lot of contact with students.
No, the contact is of a different nature and limited in scope and time. MAC guidelines recommend that custodians, bus drivers, cafeteria workers, warehouse workers, certain school monitors, and volunteers be excluded from the program. Moreover, District administrators and the Medicaid Specialist can include and exclude a wide range of staff to maximize the success of the program.
I am a secretary or classroom assistant and sometimes perform delegated "hands on" activities such as injections or tube feeding. Since those activities are clearly "medical," is there a claimable code that fits these "direct" medical activities?
Many MAC participants assume that this type of activity is reimbursable. But unfortunately, direct medical activities such as rendering first aid, giving injections, dispensing medications, etc. has a special code called "F" and is not reimbursable. However, these activities are often linked to other work that is reimbursable and can be claimed. For example, calling a student's parents to recommend coverage by the Oregon Health Plan is claimable.