IMPORTANT UPDATE FOR LEA MENTAL HEALTH PROVIDERS :
The GOOD news is that LEA's CAN get reimbursed for providing Mental Health Assessments and IEP direct services for qualifying students. Please refer to my February 2011 emailed Update Letter that discusses the payment rates and available services that are billable.
There are a whole host of Psychologists & Counselors that can bill for services, ie.... Lic. Psychs., Lic. Educational Psychs., MFT's, LCSW's, Cred. School Counselors, etc. The biggest item right away is that they ALL must hold a valid PPS prior to billing. We'll talk more as the events un-fold.
IMPORTANT QUESTIONS ANSWERED !
We are fortunate here at MBS Inc. to have a dedicated, professional, thoughtful Clients. When I'm out visiting folks they always come up with great questions. Here are the responses to recently asked questions from our Fall 2009 training sessions.
1. Is there any regulation that prohibits an LEA from putting multiple students on Assessment or Direct Therapy logs ? ANSWER : There is NO approved format for documentation. The guidelines are based upon HIPAA rules that require protection of a patients (students in the case) personal health information (PHI). Our Business Associate Agreement that we have in place covers us insofar as those regulations. FOR AN EXPANDED EXPLANATION PLEASE VISIT THE LEA ~ HELP GUIDES TAB AND "DOUBLE-CLICK" ON PDF TITLED "HIPPA.LEA Q & A".
2. What are the 5 required componets of an Initial or Tri-ennial Assessment ? ANSWER : Formalized testing, Interviews, Observations, Record Review and Report Writing
3. What are the 4 required componets of an Annual or Amended Assessment ? ANSWER : Interviews, Observations, Record Review and Report Writing
4. What if it's a Tri-ennial year but I don't do any formalized testing ? How do I bill that ? ANSWER : Since there's no testing done it becomes an Annual Assessment.
5. What if an SH student cannot respond to testing in an Initial or Tri-ennial ? ANSWER : It still can be billed as such. You made the attempt at testing.
6. Do 504 Plans count insofar as support for Nursing services ? ANSWER : No they do not. Only IEP driven services count.
What about Assessments done as part of a 504 Plan ? ANSWER : No. 504 Assessments are not as extensive as IEP Assessments and therefor don't qualify.
7. If have have a speech group ( 3 kids) scheduled for a Tuesday and only 1 student shows up how do I bill that ? ANSWER : You bill it as an individual service by using "I" in the date box.
8. I don't write out a new full report when I'm doing an Annual or Amended Assessment is it still billable ? ANSWER : Yes ~ the notes / recommendations you make on the IEP forms are suffice as the report component.
9. Do I need an RX (precription) to perform any Assessment service ? ANSWER : No ~ the referral by the parent, teacher or qualified practitioner covers Assessments. We only need RX's for some direct treatments.
10. Can I still bill Initial Assessment activity if the student is not placed ? ANSWER : Yes. Please send in ALL Initial Assessment activity.
11. Is my time spent calling parents or other school staff, coordinating servies, etc billable under LEA Medi-Cal ? ANSWER : No ~ That's considered MAA time and does not factor into the billing for LEA in any way.
12. Is "observation only" of an autistic student billable if the aide time is written into the IEP ? ANSWER : No. Observation of an autistic student is considered a behavioral service and not part of the LEA program.
