School-Based Services - Medicaid Reimbursement Assistance

Overview

CESA 6 offers school districts dedicated staff to enter, claim and comply with school-based services billing and reimbursement. School-based services (SBS) are designed to increase federal funding to Wisconsin schools to help pay for medically related special education and related services.

How We Can Help

CESA 6 provides this service to Special Education Leadership Schools and schools with the SEEDs4Schools IEP software.

The SBS benefit defines the services that can be reimbursed (see list below) by Wisconsin Medicaid for medically necessary services provided to Medicaid-eligible children in Wisconsin schools. An integral component of the SBS benefit is the Medicaid Administrative Claiming (MAC). Staff in participating districts are required to complete random time studies designating Medicaid-eligible activities. Districts also need to complete a certified public expenditure (CPE) report annually to document allowable expenditures.

To participate as a Wisconsin Medicaid SBS provider a school district, Cooperative Educational Service Agency (CESA), County Children with Disabilities Education Board (CCDEB), or charter school are required to be certified as a provider under HFS 105 53. School districts must be Medicaid certified.

The Wisconsin Medicaid SBS benefit only covers services that are listed in the student’s Individualized Education Program (IEP). Each public school child who receives school-based services must have an IEP. The IEP identifies the special education and related services for the child.


Services that can be reimbursed:

  • Speech and Language Pathology, Audiology, and Hearing Services
  • Occupational Therapy Services
  • Physical Therapy Services
  • Psychological, Counseling Social Work Services
  • Nursing Services
  • Attendant Care
  • Special Transportation Services
  • Other Developmental Testing and Assessments
  • Main Office & All Mail:
  • 2935 Universal Ct
  • Oshkosh, WI 54904
  • Phone: 920-233-2372
  • Fax: 920-236-0580
  • Conference Center
  • 2300 State Road 44
  • Oshkosh, WI 54904
  • Phone: 920-233-2372
  • Fax: 920-424-3478