Medicaid & Billing

Developmental Disabilities Eligibility Checklist

Behavioral Intervention Eligibility Checklist

Department Approved Assessment for Children's Habilitation Intervention Services (CHIS)

Functional Limitations Crosswalk - CHIS

Medicaid Billable Services

Using Public and Private Insurance Funds to Provide FAPE

Idaho Special Education Manual, p. 17

If a student is covered by public insurance or benefits, the district may access this insurance only if the parent provides informed consent. 

If a district proposes to access a parent’s public insurance to cover any of the costs associated with the provision of special education and/or related services, the district must do the following:

1. Provide written notification regarding use of public benefits or insurance to the child’s parents before accessing the child’s or the parent’s public benefits or insurance for the first time and prior to obtaining the one-time parental consent and annually thereafter. 

2. Obtain a one-time signed Consent to Bill Medicaid (CTBM) from the parent after providing the written notification regarding use of public benefits or insurance before accessing the child’s or the parent’s public benefits or insurance for the first time. This consent must specify (a) the personally identifiable information that may be disclosed (e.g., records or information about the services that may be provided to a particular child); (b) the purpose of the disclosure (e.g., billing for services); and (c) the agency to which the disclosure may be made (e.g., Medicaid). The consent also must specify that the parent understands and agrees that the public agency may access the child’s or parent’s public benefits or insurance to pay for services. Such consent may be withdrawn at any time by the parent. 

3. If the child on an IEP moves into a new district, the new district responsible for providing FAPE must provide the parents with written notification regarding use of public benefits or insurance and must obtain a new, signed CTBM before accessing the child’s or parent’s public insurance. A CTBM grants permission only to a single school district to bill Medicaid, so a new one must be obtained on enrollment in a new district.

Consent to Bill Medicaid School Based Services

Who Needs it: 

• New student

• Student returning to our district 

• Any student who receives related services

The form should be offered to the parent for their review and signature as soonas possible after the student enrolls.  If you are not meeting with the parent, send it home for a signature. Verbal consent is not sufficient. The form must be marked to indicate consent/denial of consent and signed.

Once the form is returned, scan and upload it to the student's EDPlan record and notify the Medicaid Coordinator.

Why:  This form must be signed in order to obtain a referral from the student's physician.  Without a referral, the Network Schools are unable to access the appropriate Medicaid funds and receive reimbursement for Medicaid school based services rendered.

Special Note- Reminder that all students who receive Behavior Intervention Services (Social/Emotional) AND are billable need to have a BI Checklist completed every 3 years at their triennial. The BI Checklist must also be uploaded to the student's EDPlan record and notification sent to the Medicaid Coordinator. The School Psychologist is responsible for completing the BI Checklist.