Additional School-Based Services Changes

By June 30, 2026: Billing team must implement system changes to require individual Type 1 NPI (not district-wide NPI) on all SBS claims for nursing services, occupational therapy, physical therapy, speech-language pathology, and attendant care. Work with school districts and providers to: (1) identify which providers will serve as prescribers/referrers/orderers and ensure they obtain individual NPIs and enroll with Wisconsin Medicaid as prescribing/referring/ordering providers if not already enrolled, or (2) coordinate with enrolled primary care physicians to sign off on treatment plans using their NPIs. Update billing software validation rules to reject SBS claims without compliant individual NPIs effective July 1, 2026—claims missing this requirement will be denied. Concurrently, remove specialized transportation coverage from regular vehicles with only aide assistance; update system to deny such claims and direct schools to alternative funding sources (IDEA). Notify all SBS providers and school districts of these requirements immediately. Update internal Random Moment Time Study procedures to reflect: 2-day advance notice (not 5 days), 2-day completion window (not 5 days), inclusion of August/September school days, and transition from three quarters to two semesters beginning July 1, 2026.