Medicaid

Medicaid Operations at the New York City Department of Education

The Office of Medicaid Operations is responsible for the facilitation of efforts to claim Medicaid reimbursements of related services for applicable areas including:

  • Physical Therapy
  • Occupational Therapy
  • Speech/Language Therapy

The Office works to ensure that claims submitted by the NYCDOE meet state and federal requirements.

Resources

NYS Education Department

Please use the link below to access the web page for New York State's School/Preschool Supportive Health Services Program (SSHSP). Through this site you can find information regarding New York State's Medicaid in Education program, including rules, regulations, and program alerts.

Sending Medicaid Annual Written Notification and Collecting New Medicaid Consent

Each year schools are responsible for distributing the Medicaid Annual Written Notification to families who have provided consent in past years as well as distributing and collecting new Medicaid Consent Forms from families of children with IEPs. The PowerPoint deck below includes step-by-step instructions for completing these tasks.

Medicaid Consent and CIN Collection Portal

The Office of Medicaid Operations has developed a secure web portal, where parents can electronically provide consent for Medicaid claiming and share their student’s Medicaid Client Identification Number (CIN) privately and securely. School staff who engage directly with parents of students with IEPs are asked to share the portal with them. The resources linked below will assist with this process.


Medicaid Template Consent Form

District staff may use this template form to create Medicaid Consent Forms for parents to sign during the IEP meeting. Signed forms should be scanned and uploaded using the Consent Form Upload Tool. You may be prompted to enter your DOE username and password to access the tool.

Please use the Template Medicaid Consent Form Guide for help using the form and upload tool:

Certified Monthly Roster User Guide

All center-based programs should certify their rosters in the Certified Monthly Roster (CMR). The CMR is a web-based electronic roster system that is a necessary system for processing payments to schools. For additional information regarding the annual and monthly procedures that must be followed in order to process payments, please visit the Vendor Portal CMR Application.

Creating Speech Referrals in SESIS

In December 2019, The Speech Referral Form in SESIS was updated to allow contracted Speech-Language Pathologists to create referrals for all of the students on their caseload – including PreK/3K and Charter students.

Completing a Speech-Language Referral Form

Contracted Speech-Language Pathologists who experience difficulty completing referrals in SESIS should email medicaidops@schools.nyc.gov for support. In the meantime, use the Speech Referral Portal to create an Electronic Speech Referral. If you do not have the SLP and serve under the supervision of a speech therapist with an SLP, your supervisor should complete an Electronic Speech Referral for each student on your caseload. For a comprehensive tutorial, please consult the eReferral Users’ Guide.

ICD-10-CM Diagnosis Codes for SLPs

As of October 1, 2015, all Speech-Language Pathologists (SLPs) should be using ICD-10-CM codes for all speech referrals. ICD-9 codes are no longer valid. The American Speech-Language-Hearing Association (ASHA) has made a multitude resources available to SLPs—as well as Audiologists—properly code diagnoses on referrals for service. Please refer to 2017 resources for new and revised codes.

NPI Registry Public Search

Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health & Human Service (HHS) have jointly made available a free search tool for National Provider Identifier (NPI) records. The NPI Registry Public Search is a free directory of all active NPI records. Please utilize this directory to verify accuracy of clinician credentials.

Medicaid IDs in EasyTrac for Orders

Providers can make use of eMedNY’s Enrolled Practitioner Search to verify Medicaid enrollment. While eMedNY does not include a lookup for Medicaid ID, it does allow a search by NPI, license number, or provider name. Use this website to search for NPI, license number, or provider name; if a match is returned, the user has effectively confirmed that the ordering provider is enrolled with Medicaid.

Contacts

Contact the Office of Medicaid Operations
Email: medicaidops@schools.nyc.gov
Phone: 855-740-5928 (toll free)
Fax: 718-391-6183

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