MedicaidAdministrativeMedium impact
School District
South Dakota Medicaid·SD · Speech Therapy, Occupational Therapy, Physical Therapy +1 more·Specialty Services
We identified it
Jun 21, 2026
Summary
South Dakota Medicaid issued updated billing reminders for school district and Birth to Three providers, emphasizing monthly eligibility verification, proper use of therapy assistant modifiers (HM, CO, CQ), and the TM modifier requirement for non-IEP/IFSP services that began October 1, 2025.
Action Required
Immediately: School district providers must verify Medicaid eligibility monthly in the portal before billing. Use HM modifier for SLPA services, CO modifier for OTA services, and CQ modifier for PTA services with supervising therapist's NPI in box 24J. Apply TM modifier to all non-IEP/non-IFSP services (like 504 plans). Supervising therapists should review and sign documentation for assistant services claims.