School Based Medicaid Services

Medicaid billing and IEP service delivery will be documented in TIENET Service Capture. Please see the corresponding tip sheets for support in documenting your services accurately. 

Tutorials/Resources

  TIENET Service Capture Overview

Michigan Department of Health and Human Services (MDCH)- School Based Services Manual

 Medicaid Provider Manual

Supplemental MDCH Bulletins

The Administrative Outreach Program receives partial reimbursement for the administrative costs to identify and help students who are considered "at risk" for various health problems and direct them toward proper resources.

This program generates revenue by tracking the time spent on Outreach activities by school personnel, and by factoring the district's expense for staff providing these services.

School personnel chosen in the random moment sample are expected to complete their time study. Failure to do so affects the administrative portion of the state-wide reimbursement. 

The following school personnel may participate in the Outreach portion of the School Based Services program:

• Audiologists

• Speech Pathologists

• Social Workers

• Occupational Therapists

• COTA's

• Physical Therapists

• PTA's

• RNs and LPNs 

• Psychologists

• Psychiatrists

• Orientation and Mobility Specialists

• Teacher Consultants

• Counselors

• Early Identification/Intervention Personnel

• Hearing Impaired Interpreters

• Special Education Administrators

• Program Specialists

AOP Information

AOP Non-Standard Job Information

Medicaid Reimbursement Overview

Targeted/Designated Case Management  (TCM) documentation for the Medicaid School Services Program is a unique responsibility. Where Direct Service providers document their direct service delivery as outlined in the IEP, and Personal Care Providers document their delivery of personal care services, TCMs document their coordination of care. The TCM documentation tells Medicaid how you ensure the students on your caseload have access to the services they receive in school and how they are progressing. Medicaid does not reimburse for academic support, as they are a medical payer. To further clarify and support your work in the program, please view the tip sheet, exemplars, and list of billable services provided. 

Targeted Case Management Service Capture

Targeted Case Management

Exemplary Example - Designated/Targeted Case Management

Types of Billable Services for TCM

Targeted Case Management - Detailed Presentation

Personal Care Service Explanation (11/24)

  Personal Care Service Capture Video

Personal Care Log Sheet - (Ed Center, Transition Center, Out County)

Personal Care Log Sheet - (ECSE)

Personal Care Services Authorization

Transportation Attendance Log for Special Education Students

Random Moment Time Studies (RMTS)

Participant Random Moment Completion Manual

RMTS Participant Training

RMTS At A Glance

Direct Service and Personal Care Provider RMTS Information

RMTS Tip Sheet Direct Service

RMTS At A Glance Personal Care

Monroe County ISD Quality Assurance Plan (2024)

Medicaid Documentation Rubric (Excel)

Medicaid Documentation Rubric (Word)

Physican's Therapy Order Form

Prescription Consent Form

Service Capture Internal Audit

Exemplary Example - School Social Worker

Medicaid Plan of Care Signature Form

Psychologist Tip Sheet

Psychologist Direct Service