Medicaid Referral Requirement

ISHA is aware of the revised language in the Medicaid Handbook for Local Education Agencies that states "A referral by a physician or other licensed practitioner of the healing arts within the scope of his or her practice under law is required for speech/language services. The referral must be updated annually and be maintained in the student’s health record." This has raised questions about the referral process for Medicaid billing for school speech-language pathologists. ISHA has been in contact with the Illinois Department of Healthcare and Family Services (HCFS) for clarification. HCFS is still researching the issues involved and plans to release a provider notice on the referral process. ISHA will also share this information as soon as we receive it.

Sample referral for speech language services for a student with Medicaid Form