Disclaimer: Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.
Providing Direction for Medicaid Reimbursement in the School Setting
In order for school districts to receive Medicaid reimbursement for the speech and language services they provide, those services must be provided by a NYS licensed and registered speech-language pathologist or a teacher certified to provide speech and language services who works under the "direction" of a licensed and NYS registered SLP. The following guidelines provide a framework for providing such direction.
- The licensed speech-language pathologist is under no obligation to provide this direction to the teacher of speech and hearing handicapped.
- When a speech-language pathologist indicates that s/he has provided direction to a teacher certified to provide speech and language services, s/he is signing off on having reviewed the IEP and treatment notes and on having been accessible to the teachers under his/her direction.
- The degree of direction and frequency of contacts should reflect the education and experience of the teacher certified to provide speech and language services.
- If the licensed speech-language pathologist disagrees with the implementation of a student's IEP, s/he should request a Committee on Special Education (CSE) review.
- Time should be allotted to the licensed speech-language pathologist to review documentation and to allow for conference, meeting and communication time with the teacher of speech and hearing handicapped. SLPs should document how they are providing access to the teachers under their direction.
- School districts cannot utilize license numbers for third party reimbursement or ask the licensed speech-language pathologist to sign reports for cases for which they neither provided services nor direction.
- Speech-language pathologists should only sign Medicaid Authorizations if:
- the student who received services was in that SLP's caseload; or
- the teacher certified to provide speech and language services who provided those services was under the direction of the SLP, and the SLP provided direction in accordance with the definition of direction (below).
Definition of direction:
- Consultation activities should include review of IEPs and progress notes. Student progress notes should be reviewed at least quarterly.
- Feedback should be given through regularly scheduled meetings and communications between the teacher certified to provide speech and language services and the licensed speech-language pathologist. You should maintain written documentation of these contacts.
- Recommendations regarding modification of therapeutic services made by the licensed speech-language pathologist should be documented as well as discussed during regular meetings.
The SLP providing direction is encouraged to maintain regular contact with the teachers under his/her direction.