Student referred to CSE/CPSE due to a suspected disability
Without documented written order/referral from a qualified provider the evaluation is Medicaid reimbursable.
If student is Medicaid eligible and all documentation for evaluations and ongoing services are included in student’s record, Medicaid may be billed.
If student is not classified with a disability, the evaluation is Medicaid reimbursable.
Student is classified with a disability. CSE/CPSE meets to develop IEP
Was a disability identified?
Prior to the evaluation, was a written order/referral obtained from a qualified provider?
Evaluation(s) reflected in IEP; services to be delivered included in IEP and written order/referral(s) for evaluations and services must be included in student’s record
WHEN ARE EVALUATIONS MEDICAID REIMBURSABLE?