MAA Region 6 LEC/LEA Billing
School-Base Medi-Cal Administrative Activities (SMAA)
This federally funded program allows school districts to be reimbursed for costs incurred while performing certain Medi-Cal Administrative Activities. This program not only connects students and their families with the Medi-Cal program, but it brings much needed revenue into our schools.
New Random Moment Time Survey Methodology
The state approved Random Moment Time Survey (RMTS) plan was implemented 2014-2015 school year. RMTS is more statistically valid as it chooses participants, at random, to answer three questions, based on a specific minute in time, to explain what they are doing, who they are doing it with, and why they are doing it. The answers to these three questions will be sent to professional coders who will then place the activity in the appropriate code for potential reimbursement. Because this is random, the moment a participant may be given could be during lunch or during an IEP. Also because of the random nature, a participant may never be chosen to complete a moment, but the district would still receive reimbursement for that employee based on a percentage of their salary and the percentage of Medi-Cal students in the district (similar to the invoice process associated with the five day worker log).
Local Educational Agency Medi-Cal Billing Option (LEA Billing)
The LEA Medical Billing Option allows school districts to be reimbursed for health services at fee-for-service rates. Providers submit claims for each service they provide to a student. These services must be in the IFSP/IEP and deemed medically necessary. We can submit claims for Assessments, Treatments/ Direct Services. Direct service providers are typically the School Psychologist, Speech Language Pathologist, Nurse, Social Worker, Counselor, and Audiologist. Some transportation may also be reimbursed. This program requires extensive documentation and reimbursed monies are restricted dollars.
LEA Medi-Cal Billing Option Forms: