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October 2022
The Washington State School-Based Health Care Services (SBHS) Program is administered by the Health Care Authority (HCA). School districts participating in the SBHS Program may receive reimbursement for providing health care-related services to Title XIX Medicaid-eligible students with Individualized Education Programs (IEPs) or Individualized Family Service Plans (IFSPs). Visit the SBHS webpage for more information.
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Below are some helpful resources and trainings for SBHS Medicaid District Coordinators. These trainings have been updated for the 2022-23 school year:
Updated provider trainings are now available!
HCA updated the provider trainings to reflect new telemedicine billing guidance. Providers new to Medicaid billing, as well as returning providers, are encouraged to view the training related to their specialty to ensure they understand Medicaid billing requirements:
- Billing for mental health services-video/pdf
- Billing for nursing services-video/pdf
- Billing for occupational therapy services-video/pdf
- Billing for physical therapy services-video/pdf
- Billing for speech-language therapy services-video/pdf
HCA recently updated the SBHS billing guide, effective for dates of service on and after October 1, 2022.
Updates to the guide include:
- Clarification on which CPT/HCPCS codes can be billed through audio-only telemedicine
- Link to HCA's new resource Confidentiality Toolkit
- General clean-up and clarification throughout the guide
A full list of changes can be found in the What has changed? table on pages 3-4 of the billing guide.
Any questions about the guide should be directed to HCA's SBHS program manager.
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When schools closed in March 2020 due to the COVID-19 pandemic, the SBHS program created an SBHS COVID-19 FAQ to provide guidance on how to bill for IEP/IFSP services provided through distance learning models (i.e., through telemedicine).
With the end of the public health emergency approaching on October 31, the SBHS COVID-19 FAQ has been removed from the SBHS webpage. All telemedicine billing instructions for the SBHS program can now be found in the SBHS billing guide.
Attention SBHS Coordinators! Remember to update your district's Provider and Contact Update form and email an updated copy to HCA's SBHS program manager with a cc to the district's billing agent (if applicable) by October 31! If you need a copy of the form your district submitted last year, please email HCA's SBHS program manager.
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