FDOE-Sponsored Medicaid Tracking & SDAC Systems
Medicaid Tracking System (MTS) 3.0 - The Medicaid Tracking System (MTS) 3.0 is a web-based application provided by the Bureau of Exceptional Education and Student Services (BEESS), Florida Department of Education (FDOE) to districts at no cost, allowing service providers to document and request reimbursement for services provided to students with disabilities through the Medicaid Certified School Match Program.
MTS 3.0 Features - Providers can document and bill for speech therapy services, physical therapy services, and occupational therapy services, as well as nursing services. Providers can generate personal reports of their documented services. Administrators can create detailed reports related to services documented by providers. Administrators can generate/upload the following files:
- 270 Medicaid Eligibility Request file for submission to AHCA using two student data files
- 271 Medicaid Eligibility Response file
- 837 Professional Health Care Claims (billing) file
Contact MTSSupport@fldoe.org for more information.
Medicaid Tracking System (MTS) 2.0 - MTS 2.0 is a desktop-based (versus web-based) school district Medicaid billing software application. It is designed to facilitate a school district's student Medicaid eligibility checks and student Medicaid billing, as performed under the Medicaid Certified School Match Program. MTS 2.0 is provided at no cost to school districts by the Bureau of Exceptional Education and Student Services (BEESS), Florida Department of Education (FDOE).
MTS 2.0 Features
- Can bill all service types which are billable under the Medicaid Certified School Match Program.
- Draws its core data from your School Information System (SIS) via a "Student File" and an optional "Exceptionality File" which are produced by your IT Department on monthly basis for importation into MTS 2.0.
- Enables automated mass student Medicaid Eligibility checks to be performed monthly. With the received eligibility data, you can generate paper based or PDF based monthly student Medicaid eligibility reports.
- Streamlined Medicaid billing record entry. To bill a service, you only need to enter Student ID, Service Provider ID, Date of Service, Procedure Code, Diagnosis Code, and Units.
- You can enter your billable service data from paper service documents, or from electronic service documents (such as Microsoft Word or Excel documents, or PDF documents, etc.).
- Optionally, you can import service records into MTS 2.0 in bulk from other software applications using a specifically formatted Microsoft Excel file, to avoid having to hand enter that service data into MTS 2.0.
MTS 2.0 Architecture - MTS 2.0 is a Microsoft Windows desktop database application. It is designed for installation in your school district central office's Medicaid department, either as a single-user installation on one computer, or as a multi-user installation on multiple client computers in conjunction with a shared data folder on an IT Department file server. Multi-user installations typically contain up to five users, but more users can be supported.
Technical support on installation and operation of MTS 2.0 is provided by Nanci English, Medicaid in Schools Consultant, Student Support Services Project, nanci.english@fldoe.org.
Tools and Forms
- Fee-for-Service School Certified Match Reimbursement Report - on the Florida Agency for Health Care Administration website, updated quarterly
- Map of Florida, Size-Alike Districts, 2019
- Medicaid Certified School Match Program: Potential Annual Medicaid Reimbursement Worksheets, Updated September 2018
- Medicaid Parental Consent and Annual Notification Checklist
- Notice of Parental Rights Concerning the Use of Public Benefits or Insurance
(in Spanish
, in Haitian-Creole
)
- Parental Consent Form for Release of Personally Identifiable Information for Medicaid Reimbursement for IEP and Non IEP Services Combined
(in Spanish
)
- Parental Consent Form for Release of Personally Identifiable Information for Medicaid Reimbursement
(in Spanish
, in Hatian-Creole
)
- Parental consent and notification requirements for sharing information related to Medicaid and Private Insurance Billing in Florida Administrative Code-FAC6A-6.03028
Agency for Health Care Administration (AHCA) and Centers for Medicare & Medicaid Services (CMS) Guidance
- 10/2/20 - UPDATED - Medicaid School-Based Services - Frequently Asked Questions (FAQs) Regarding Telemedicine Flexibilities for School Districts, Private, and Charter Schools During COVID-19
- 7/24/20 - School District Federal Medical Assistance Percentages (FMAP) Rate
- 4/16/20 - AHCA - Telehealth Guidance Clarification
- 4/9/20 - Random Moment Time Sampling Guidance for School District Administrative Claiming
- 4/8/20 - AHCA Answer - Telemedicine by Telephone
- 4/2/20 - School District Administrative Claiming Reconsideration
- 4/2/20 - SDAC RMS Reconsideration Request Form
- 3/31/20 - Telemedicine Guidance for School-Based Services
- 11/18/19 - Florida Medicaid Private and Charter School Enrollment Overview
- 4/24/19 - Coding RMS moment when selected participant is not scheduled to work or in on paid leave
- 1/17/19 - Medicaid managed care plans and MOAs with school districts
- Archived AHCA Guidance (Click here.)
AHCA Rate Calculations
Medicaid Handbooks, Guides, Fee Schedules, and Forms
- Fee For Service Monitoring Checklist
- Fee For Service Monitoring Instrument
- Medicaid Certified School Match 2020 Fee Schedule, Updated November 2020
- Medicaid Certified School Match Program Coverage and Limitations Handbook 2005
- CMS Medicaid School-Based Administrative Claiming, May 2003
- Job Title Certification Checklist
- Job Title Certification Form (AHCA-November 2016)
- Medicaid School District Administrative Claiming Guide, November 2013
- RMS Monitor Review Process, Simplified
- SDAC Monitoring Tool
- SDAC RMS Reconsideration Request Form
Notes — Conference Calls Related to Schools and Medicaid
- PowerPoint - Schools and Medicaid Quarterly Call
- CARES Provider Relief Fund Phase 3 Application
- Medicaid Call Notes
- Notes
- PowerPoint – Schools and Medicaid Quarterly Call
- CARES Act/Medicaid/Chip Funds Fact Sheet
- HRSA Provider Relief Fund: Medicaid and CHIP Provider Distribution Fact Sheet
- CS/HB 81
- Families First Coronavirus Response Act – Increased FMAP FAQs
- Notes
- PowerPoint – Schools and Medicaid Quarterly Call
- 2020 Fee Schedule Comments
- COVID-19 Frequently Asked Questions
for State Medicaid and Children’s Health Insurance Program Agencies, 4/2/2020
- Joint Guidance on the Application of the Family Educational Rights and Privacy Act and the Health Insurance Portability and Accountability Act of 1996 to Student Health Records, December 2019 Update
- HB 81, 2020 Florida Legislature
- School District Administrative Claiming Reconsideration
- SDAC RMS Reconsideration Request Form
- Telemedicine Guidance for School-Based Services
- PowerPoint – Schools and Medicaid Quarterly Call
- AAC Concurrence Procedure, Brevard County School District
- AHCA’s SMMC Roll Out Schedule
- AHCA’s SMMC Health and Dental Plans
Emails from FDOE/USF to School District Medicaid Contacts
Related to Schools and Medicaid
- 6/8/20 - Flexibility with Fee For Service Requirement
- 4/23/20 - Medicaid School-Based Behavioral Health Procedure Codes
- 4/16/20 - AHCA Telehealth Guidance Clarification
- 4/15/20 - Medicaid Transportation Rates Memorandum
- 4/9/20 - Random Moment Time Sampling Guidance for School District Administrative Claiming
- 4/8/20 - AHCA Telemedicine by telephone
- 4/2/20 - AHCA Medicaid SDAC Filing Process Update
- 4/2/20 - AHCA School District Administrative Claiming Reconsiderations for Q3 2018 - Q2 2019
- 3/31/20 - Medicaid School-Based Services Delivered via Telemedicine
- 3/30/20 - Update Information
- 3/17/20 - RMTS Impact/School Closures
- 2/12/20 - School District Administrative Claiming - Forms Clarification
- 1/29/20 - 2020 Fee Schedule Updates
- 11/5/19 - Medicaid Re-enrollment Tips from Districts
- 10/31/19 - Medicaid re-enrollment information from AHCA
- 8/19/19 - RY 2021 Payment Error Rate Measurement (PERM) for Florida
- 4/29/19 - Charter School Participation in Medicaid School-Based Services Fee-for-Service
- 4/24/19 - SDAC: Coding random moment when selected participant is not scheduled to work and not on paid leave
- Archived 2015 Emails from FDOE/USF to School District Medicaid Contacts Related to Schools and Medicaid
Important Links
- AHCA Rules
- Sign-up page for Florida Medicaid Health Care Alerts
Healthy Kids Corporation (KidCare) arranges health care coverage for Florida's uninsured children.
National Alliance for Medicaid in Education represents the nation's Medicaid and Education agency staff, along with local education agency administrators, with programmatic responsibility for administering Medicaid's Administrative Claiming and Direct Billing of Health Related Service programs in schools.
U.S. Department of Health and Human Services - Office of Inspector General Reports- 11/24/20 - Florida Received Unallowable Medicaid Reimbursement for School-Based Services
- 9/21/20 - Connecticut Did Not Meet Federal and State Requirements for Claiming Medicaid School-Based Child Health Services for Hartford Public Schools
- 8/14/20 - Nebraska Claimed Unallowable School-Based Administrative Costs Because of Improper Coding of Random Moment Timestudy Responses
- 11/8/19 - New Jersey Improperly Claimed Tens of Millions for Medicaid School-Based Administrative Costs Based on Random Moment Sampling That Did Not Meet Federal Requirements
- 12/6/18 - Vulnerabilities Exist in State Agencies' Use of Random Moment Sampling To Allocate Costs for Medicaid School-Based Administrative and Health Services Expenditures
- 8/14/17 - Texas Improperly Received Medicaid Reimbursement for School-Based Health Services
- 3/15/17 - Mississippi Claimed Millions in Unallowable School-Based Medicaid Administrative Costs
- 10/6/16 - North Carolina Claimed Millions in Unallowable School-Based Medicaid Administrative Costs
- 9/12/2016 - Michigan Improperly Received Medicaid Reimbursement for School-Based Health Services
- 7/13/16 - Alabama Claimed Millions in Unallowable School-Based Medicaid Administrative Costs
- 9/30/15 - Massachusetts Generally Complied with Medicaid Requirements When Claiming Reimbursement for School-Based Health Services
- 8/6/14 - Kansas Improperly Received Medicaid Reimbursement for School-Based Administrative Costs
- 1/22/13 - Arizona Improperly Received Medicaid Reimbursement for School-Based Administrative Costs
- 4/3/12 - Review of Colorado Direct Medical Service and Specialized Transportation Costs for the Medicaid School Health Services Program for State Fiscal Year 2008
- 10/6/11 - Review of Kansas Medicaid Payments for the School District Administrative Claiming Program During the Period April 1, 2006, Through March 31, 2009
- 3/18/10 - Review of Missouri Medicaid Payments for the School District Administrative Claiming Program for Federal Fiscal Years 2004 Through 2006
Shared District Resources
- Common Psychological and Social Work Billing Codes
- Detailed Comparison Spreadsheet (from Milly Markle, Taylor County)
- Nursing Codes
- Occupational Therapy ICD-9/ICD-10 Crosswalk
- OT/PT Codes
- Physical Therapy ICD-9/ICD-10 Crosswalk
- Psychology/Social Work ICD-9/ICD-10 Crosswalk
- Speech-Language Diagnosis Codes
- Speech-Language Pathology ICD-9 to ICD10 Diagnostic Codes
- Speech-Language Therapy ICD-9/ICD-10 Crosswalk
Archived 2012-2016 Annual Schools and Medicaid Meetings