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Student referred to  CSE/CPSE due to a suspected disability

Without documented written order/referral from a qualified provider the evaluation is not 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.

Y

If student is not classified with a disability, the evaluation is not Medicaid reimbursable.

Y

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?

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