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
Center for Medicare/Medicaid Services (CMS) Guidance
AHCA Guidance
- 10/8/20 - Private and Charter School Enrollment Update
- 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 Transportation Rate Calculations
Medicaid Handbooks, Guides, Fee Schedules, and Forms
Medicaid Certified School Match Program
Medicaid School District Administrative Claiming Program
Notes — Conference Calls Related to Schools and Medicaid
Quarterly Call (10/29/20)
Quarterly Call (7/9/20)
- 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
Florida Agency for Health Care Administration (AHCA) is responsible for the administration of the Medicaid program, for the licensure and regulation of health facilities and for providing information to Floridians about the quality of the health care they receive in Florida.
- 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- 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
- 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
Examples of ICD-10 codes and ICD-9 to ICD-10 conversions shared by school districts:
- 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