Medicaid Rehabilitative Therapy

• Speech-Language Therapy 

• Occupational Therapy

• Physical Therapy 

All providers shall maintain a clinical record for each Medicaid-eligible beneficiary that fully describes the extent of the treatment services provided.

 The clinical record must contain documentation sufficient to justify Medicaid participation and should allow an individual not familiar with the beneficiary to evaluate the course of treatment.

 Medicaid File must contain the following documents:

• Student Medicaid Eligibility Form from DHHS - example

• Medicaid General Consent 

• Annual Notification Letter

• Referral Form - Who can refer for services?

  • Speech Language Therapy Referral Form

  • Occupational Referral Therapy Form

  • Physical Therapy Referral Form

• Evaluation and other assessments

• Treatment Plan (IEP, or IFSP) (when services are recommended)

• Clinical Service Notes (CSN) (document services)

• Progress Service Notes (summarize therapy services at least every 90 days)

• Other documents relevant to the care and treatment of the student (Lab reports, medical reports, additional assessments, and court orders)

• Staff Credentials (Staff SCLLR license and Office of Inspector General Report

Other forms and information:

• IEP Supplemental Form

• HIPAA and Record Retention Information 

Staff must meet all applicable Medicaid provider qualifications, as well as the applicable state licensure regulations, in addition to any specified requirements by the South Carolina Department of Education for the provision of Medicaid school-based services. The contracted LEA is responsible for ensuring the individuals rendering Medicaid school-based services are approved, credentialed, or licensed.

 All subcontracts (e.g., billing contracts, contracted providers, etc.) are subject to the terms of the LEA’s contracts with SCDHHS, and the LEA provider is held solely responsible for the performance of the subcontractor.

All supervisory staff licensed by Labor, Licensing and Regulation (LLR) must adhere to any provisions as required by LLR.

In addition

Medicaid Updates SBSS Therapy Services - 2-23-23

Development  of an  IDEA and Medicaid Compliant Treatment Plan - 4-19-2023

Medicaid Updates School-Based Therapy Services Date 9-1-2023 

Medicaid Updates SBRS Therapy Services Fall Training 12-2023 

Medicaid SBRS Therapy Services Training - 2-14-24

Medicaid SBRS Therapy Services Reference Guide - 8-2024