School Based Services
The School Based Service (SBS) benefit has been established according to s. 49.45(39), Wis. Stats. This benefit is designed to increase federal funding to Wisconsin schools to help pay for medically related special education and related services. Through the SBS benefit, Medicaid enrolled SBS providers (school districts) may request reimbursement from Wisconsin Medicaid for medically necessary covered services provided to children eligible for Medicaid and BadgerCare Plus.
SBS must be identified in the child's Individualized Education Program (IEP) and certain requirements must be met. Reimbursable services include the following:
● Developmental testing and assessments when resulting in a created or revised IEP
● Attendant Care services
● Nursing and delegated nursing services
● Occupational Therapy
● Physical Therapy
● Psychological services, counseling and social work
● Speech and Language Pathology (SLP), audiology and hearing
● Alternative Transportation
CESA #11 provides administration and billing services to districts seeking Medicaid reimbursement. This service provides training to business managers, bookkeepers and special education directors in completing their state/federal mandated quarterly and annual financial cost reports.
CESA #11 provides leadership representation for audits and claim negotiations; training and updating to new and current personnel; SBS Medicaid consultation with service providers, administrator and administrative support personnel by onsite visits or phone; monitoring and reporting of Medicaid updates and changes affecting SBS; monthly eligibility verification.