Direct Billing : School-Based Mental Health

mental health blocks

School Districts and Education Service Cooperatives (ESC) may be approved to seek Medicaid reimbursement as a School-Based Mental Health (SBMH) provider for services provided to students by a mental health professional who is an employee of the Local Education Agency (LEA).  The LEA must first meet the requirements in the Arkansas Department of Education (ADE) SBMH Manual and obtain ADE certification prior to beginning the Arkansas Medicaid provider application process for SBMH.

Application Process

The following process is necessary for LEA SBMH providers:

  1. Mental health professional must be an employee of the LEA and an approved mental health provider with Arkansas Medicaid.
  2. Obtain SBMH application approval outlining the service program. 
    SBMH Manual and Certification Application_Sept 2021.
  3. Obtain Arkansas Medicaid provider approval of the enrollment application.  See the AR Medicaid in the Schools: Direct Billing page for more details and instructions.

Confidentiality

Confidentiality of all client records should be maintained according to Title 42 of the Code of Federal Regulations, Part II. 

Parental Consent for Services 

In compliance with the Family Education Rights and Privacy Act (FERPA) (20U.S.C. & 1232g; 34 CFR Part 99), parental consent is necessary to share identifiable information/student education records to be disclosed to Third Party Billing Vendor for the purpose of billing Medicaid and/or private insurance. 

Extension of Benefits

An LEA may provide up to ten therapeutic sessions before a Primary Care Physician referral is required.  If a student is in need of additional services beyond the designated service threshold, the LEA may seek approval for an extension of benefits from eQHealth Solutions via eQSuitesSee the ‘Outpatient Behavioral Health eQSuite® Step by Step User Guide’ under Related Files on this page for more details

 


For more information, please contact:

Beth Mathys, School-Based Mental Health Coordinator
Arkansas Department of Education
Division of Elementary & Secondary Education
Four Capitol Mall, Mail Slot #14
Little Rock, AR 72201
Phone: 501-683-3604
Fax: 501-682-4886
Email:  Beth.Mathys@ade.arkansas.gov