Preschool/School Supportive Health Services Program – SSHSP
The Preschool/School Supportive Health Services Program – SSHSP – was developed, and is administered jointly, by the New York State Department of Health (DOH) and the New York State Department of Education (SED).
SSHSP helps 4201 schools, school districts, and counties get Medicaid reimbursement for students with disabilities who have an Individualized Education Program (IEP). These students are from ages five up to 21 years of age. Preschool students (ages three to five) may also be covered.
All Medicaid requirements must be met to be reimbursable. These requirements are:
Medically necessary and included in a Medicaid covered category in accordance with 1905(a), 1905(r)(5) and/or 1903(c) of the Social Security Act;
Ordered or prescribed by a NYS Medicaid enrolled physician or other licensed practitioner acting within his or her scope of practice under New York State law;
Included in the student’s Individualized Education Program (IEP);
Provided by qualified professionals under contract with or employed by a school district or a county in the State or the City of New York;
Furnished in accordance with all requirements of the State Medicaid Program and other pertinent federal and State laws and regulations including those for provider qualifications, comparability of services, and the amount, duration and scope provisions and
Included in the State’s Medicaid plan or available under Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services.
A school district or county must be enrolled as a Medicaid provider to bill for Medicaid reimbursement.
SSHSP Medicaid Reimbursable Services*:
*Preschool/School Supportive Health Services Program (SSHSP) Medicaid-In-Education Medicaid Provider Policy and Billing Handbook (Update 8), Page 6
