Family and Children's Medicaid MA-3540 Medicaid Covered Services
xxix. Health related services provided in public schools
Refer to DMA’s website at http://www.dhhs.state.nc.us/dma/mp/mpindex.htm for specific coverage criteria, prior approval requirements, and service limitations.
A. Covered Services
1. Audiology services
2. Speech/language services
3. Occupational therapy
4. Physical therapy
5. Psychological/Counseling services
6. Nursing Services
NOTE: Relative to all services above and for recipients under the age of 21 in regard to EPSDT requirements, see I. and XXXVIII. of this manual section.
1. Treatment services must be ordered by a physician.
2. Coverage is limited to Medicaid recipients in public schools who are applying for or receive special education as part of Individualized Family Services Plan (IFSP) or Individualized Education Plan (IEP).
3. Services rendered to recipients in public schools must be provided in the setting identified on the IEP.
4. A maximum of one assessment service per service type is billable in a six month period.