Posted on 10/30/2015 at 12:00 AM by
A number of school nurses are questioned when using the HS code on page F of the IEP. Often special education teachers are unfamiliar with this code. Having been taught that PP is the code to use for a Medicaid billable para, they question. Probably the simplest way to explain PP is to state that a student should have a behavior intervention plan (BIP) to use this code. How can you tell by looking at the IEP? Check out the image below. See how both the first two boxes are checked under behavior? This confirms that the student has a BIP.
For this student the proper code would be PP. This is true because the student has both a BIP and an IHP. Below is the entry on page F to correspond for this student.
For any student who only has two checks on page B under health and "No, behavior is not a concern" checked the correct code is HS. Below is an example of this box on page F.
HS code description reads: " Services provided by a qualified person trained by an RN or advanced degree nurse." This code is used successfully for Medicaid billing. In the above example, the IHP would focus on providing the services listed in the box. Medicaid minutes that can be billed per month is 2420. The school nurse should show evidence of meeting with the para to answer questions and to observe technique. The HS code ONLY applies to the para. This code should NEVER be used to describe services provided by the school nurse.
The Department of Education stated the following in its update and guidance provided in July, 2015 with release of the updated AEA Program Manual.
"Paraprofessional service codes: Beginning in 2016-17, determinations of an IEP’s weighted enrollment factor (WEF) will take into account only services coded as Paraprofessional Services - Medicaid Billable (PP), Paraprofessional Services - Non-Medicaid Billable (TA), and Health Services (HS). When regular, ongoing paraprofessional services are being provided, always use the PP or TA codes. When regular, ongoing services are provided by a qualified person trained by an RN or advanced degree nurse, always use the HS code. Do not use an activity/support designation such as Supplementary Aids or Support for School Personnel when paraprofessional services are regular and ongoing."
Hope this clears up any confusion!