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 Student Education (BESE), 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 Student Education (BESE), 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, email@example.com.
EMACS – Electronic Medicaid Administrative Claiming System - The EMACS is a random moment sample (RMS) web application which supports Florida public school districts in meeting the requirements of the Florida Medicaid School District Administrative Claiming (SDAC) program. The EMACS is utilized by the EMACS Group, which is composed of very-large, large, medium, and small Florida public school districts. The Group's member districts work cooperatively to complete the quarterly SDAC RMS. By working together on the random moment sample, the EMACS Group spreads the RMS workload proportionately among its member districts. The EMACS Group and the EMACS web application are managed and supported by the EMACS Data Manager. The EMACS Data Manager is part of the Bureau of Student Support Services (BoSSS), Florida Department of Education (FDOE), which provides the EMACS web application, and the services of the EMACS Data Manager, at no cost to member districts in the EMACS Group. No contract is necessary for a district to become a member of the EMACS Group.
- No contract and no cost for a school district to participate.
- The EMACS web application can be accessed using popular desktop/laptop/tablet web browsers.
- The EMACS web application and the EMACS Data Manager support the EMACS Group's member school districts end-to-end in the SDAC random moment sample process.
- Each district in the EMACS Group performs the Activity Coding on its own RMS Moments.
- The EMACS Data Manager provides a review of all the Activity Coding done by the EMACS Group member districts during the Quarter.
Contact Nanci English, Medicaid in Schools Consultant, Student Support Services Project, firstname.lastname@example.org for more information.
- Section 409.908, F.S., Reimbursement of Medicaid providers
- Section 1011.70, F.S., Medicaid certified school funding maximization
- Section 409.9071, F.S., Medicaid provider agreements for school districts certifying state match
- Section 409.9072, F.S., Medicaid provider agreements for charter schools and private schools
Medicaid Handbooks, Guides, Fee Schedules, and Forms
- Draft MCSM Document Checklist 2019
- Fee For Service Monitoring Checklist
- Fee For Service Monitoring Instrument
- Medicaid and School Health: A Technical Assistance Guide
- Medicaid Certified School Match 2021 Fee Schedule
- 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
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, 2020
- 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 )
- OSEP Q&A
- 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
- 6/11/21 - MCSM Medical Record Submission
- 6/3/21 - Procedure codes for school-based behavioral health services
- 5/27/21 - Draft MCSM Document Checklist Email
- 5/14/21 - School-Based Provider Enrollment Email
- 2/19/21 - Recent Changes Regarding Florida Medicaid’s Certified School Match Program and School-Based Services
- 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
- 9/28/2020 - AHCA School-Based FAQ Update
- 8/17/2020 - AHCA Guidance for Florida Medicaid Coverage of Telemedicine Services for School Based Services
- 7/24/20 - School District Federal Medical Assistance Percentages (FMAP) Rate
- 4/23/20 - Medicaid School-Based Behavioral Health Procedure Codes
- 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 - AHCA Medicaid SDAC Filing Process Update
- 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
- 3/17/20 - RMTS Impact/School Closures
- 2/12/20 - School District Administrative Claiming - Forms Clarification
- Archived AHCA Guidance (Click here.)
AHCA Rate Calculations
Notes — Conference Calls Related to Schools and Medicaid
AHCA Conference Call (5/27/21) - Zoom RecordingMedicaid in Schools Virtual Conference (3/2/21-3/3/21)
- 2021 Annual Medicaid in Schools Conference Agenda
- March 2 Resources
- March 2, 2021 Conference Recording
- 9:00 AM Keynote
- 9:15 AM AHCA SDAC Training
- 11:00 AM Maximizing Medicaid Reimbursement
- 11:50 AM Action Plan Implementation
- 12:15 PM Navigating the Florida Medicaid Web Portal and Remittance Advice
- March 3 Resources
- March 3, 2021 Conference Recording
- 9:00 AM Impact of Medicaid Reimbursement in Schools
- 9:15 AM Meet YOUR Student Support Services Team
- 10:00 AM Fixed and Growth Mindset
- PowerPoint - Schools and Medicaid Quarterly Call
- CARES Provider Relief Fund Phase 3 Application
- Medicaid Call 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
- 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
Florida Department of Education (FDOE)/University of South Florida (USF) Guidance
- 5/27/21 - AHCA Meeting
- Medicaid in Schools Questions Submitted May 7, 2021
- 4/19/21 - FDOE Memo School Based Services
- 6/8/20 - Flexibility with Fee For Service Requirement
- 4/15/20 - Medicaid Transportation Rates Memorandum
- 3/30/20 - Update Information
- 1/29/20 - 2020 Fee Schedule Updates
- Archived FDOE/USF Guidance
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
- 7/20/21 - New York Improperly Claimed $439 Million In Medicaid Funds for Its School-Based Health Services Based on Certified Public Expenditures
- 6/25/21 - Kentucky Claimed Millions in Unallowable School-Based Medicaid Administrative Costs
- 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
- Archived Office of Inspector General Reports
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 Annual Schools and Medicaid Meetings