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School-Based Mental Health Services and Medicaid Billing Requirements
School districts and Education Service Cooperatives (ESCs) may seek Medicaid reimbursement as a School-Based Mental Health (SBMH) provider for services delivered by a qualified mental health professional who is an employee of the Local Education Agency (LEA), provided the LEA first meets the requirements outlined in the ADE SBMH Manual and obtains ADE certification before applying for Arkansas Medicaid provider enrollment. The mental health professional must be an approved Arkansas Medicaid provider, and the LEA must receive approval for both the SBMH service program and Medicaid enrollment. All student records must be maintained in compliance with Title 42 CFR Part II, and parental consent is required under FERPA to disclose identifiable student information for Medicaid or private insurance billing. An LEA may provide up to ten therapeutic sessions without a physician referral; services beyond this threshold require prior approval for an extension of benefits through Atrezzo via Acentra Health.
Useful SBMH Links
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