April 22, 2021

Special Education Updates

April 2021 Directors' Forum Recording Available

The captioned recording of the April 2021 Special Education Directors' Forum is now available on the Minnesota Department of Education (MDE) Special Education Division Mediasite website. The recording includes links to the forum evaluation and accessible PowerPoint presentation; use the information ("i") button at the lower right of the screen.

View the April 2021 Special Education Directors' Forum recording on the Mediasite website.

Positive Behavioral Interventions and Supports (PBIS) Application Deadlines Extended

PBIS Minnesota is extending the application date for teams to apply for Cohort 17 School-Wide PBIS training (Summer 2021-Spring 2023) on its Application for School Training webpage. The application window for Cohort 17 applications is now May 10, 2021.

If you have any questions or need assistance, please contact your Regional Coordinator.

Sustaining Exemplar Applications Now Open

Minnesota PBIS Sustaining Exemplar Recognition recognizes exemplar schools and districts that are implementing, sustaining, and achieving positive outcomes through PBIS. For more details about applying for cohort, noncohort or district recognition visit the Minnesota PBIS Sustaining Exemplar Schools webpage. Note: The previous April 9 deadline for this recognition as stated has been extended.

School-Based Community Services for Children Enrolled in Medical Assistance

The Department of Human Services (DHS) understands schools are interested in billing for services provided in schools to students enrolled in Medical Assistance (MA) when the student does not have an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP) or the provided service is not part of an IEP or IFSP. DHS is making changes to their systems to allow schools to bill and receive payment for these services, effective July 1, 2021.

School-Based Community Services

School-Based Community Services are not services that are newly covered, they are currently part of the Minnesota Health Care Programs (MHCP) benefit package. Minnesota public schools have not billed for these services previously, but now can. Minnesota public schools may bill for the following services:

• Occupational Therapy.
• Physical Therapy.
• Speech Language Pathology and Audiology.
• Outpatient Mental Health.
• Public Health Nursing Clinic.
• Interpreters (when needed during a medical service).

MHCP considers School-Based Community Services to have the same requirements as MHCP services provided outside the school. DHS requires schools to meet all requirements and coverage criteria as for services delivered by other MHCP service providers in communities.

School Participation Requirements

• Minnesota public schools not already enrolled with MHCP must enroll before billing for School-Based Community Services. Schools may submit the School-Based Community Services Intent to Bill (DHS-8084) to Provider Eligibility and Compliance during the enrollment process or when they are ready to provide school-based community services.
• Minnesota public schools already enrolled in MHCP as an IEP service provider must submit the School-Based Community Services Intent to Bill (DHS-8084) to MHCP Provider Eligibility and Compliance so that internal codes can be added to your school’s provider file for reimbursement for school-based community services.
• It could take 30 days to update enrollment files, so do not delay in enrolling with MHCP.

School-Based Community Services Responsibilities

The school must be identified as the pay-to provider for School-Based Community Services and will be responsible for the services provided in their school. As the employer of the service provider, schools must ensure each service provider is actively enrolled with MHCP and is not an Excluded Provider.

Managed Care Organizations (MCOs) and Other Payers

Schools must contact Managed Care Organizations (MCO) and other payers for their instructions to bill School-Based Community Services. Schools will follow MCO enrollment procedures for the school and, if necessary, the treating provider. Schools must bill private insurance prior to billing MHCP for School-Based Community Services, following the private insurer’s procedures. If the child is enrolled in an MCO, the school should contact the MCO for billing requirements.

Training and Guidance

DHS is partnering with MDE to provide training to all Minnesota public schools on how they can bill for School-Based Community Services. View the training schedule and registration information on the GovDelivery website. Information is also available to schools through the MHCP Provider Manual sections for each specific service. See the Provider Basics section for general enrollment and billing information and our MHCP provider training webpage.

Billing for School-Based Community Services

Use MN–ITS 837P Professional Claim.

• DHS will reimburse schools at the MHCP fee schedule rate.
• Follow Current Procedural Terminology (CPT) and Healthcare Common Procedural Coding System (HCPCS) coding and requirements. See the Coding Schemes section in the Billing Policy Overview in the MHCP Provider Manual.
• Identify treating (rendering) provider on the claim.
• Identify ordering and referring provider on the claim.