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Chapter 538 School-Based Health Services

This service provides non-emergency medical transportation for students with attendants, either with or without a bus aide. It allows for up to four one-way trips per instructional day, between school, home, or a designated stop.

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Chapter 538 School-Based Health Services

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  1. Chapter 538 School-Based Health Services Transportation

  2. Demographics

  3. Two Codes to Choose __T2001 SE – Non-Emergency Medical Transportation – with Bus Aide. T2002 SE – Non-Emergency Medical Transportation – without Bus Aide. (Up to 4 one-way trips per instructional day.) Locations would be school, home, or designated stop (DS). If other than these indicate the specific location. Driver and aide signatures are only verifying the student’s total monthly trips.

  4. Non-Emergency Medical Transportation with Bus Aid • Procedure code: T2001SE • Service Unit: TRIP • Service Limits: Four one-way trips per instructional day • Definition: Non-emergency medical transportation with attendant is a service in which a one-way transport of a member by a vehicle other than an ambulance is provided. If more than one member is being transported, each members’ transport to the Medicaid service is billed. Non-emergency transportation with an attendant may only be billed when a Medicaid covered service is billed for the same date of service and the attendant is present during the transport.

  5. Non-Emergency Transportation • Procedure code: T2002 SE • Service Unit: TRIP • Services Limit: Four one-way trips per instructional day • Definition: Non-emergency medical transportation is a service in which a one-way transport of a member by a vehicle other than an ambulance is provided. If more than one member is being transported, each member’s transport to the Medicaid service is billable. Non-emergency transportation may only be billed when a Medicaid covered service is billed for the same date of service.

  6. Documentation

  7. Documentation • Documentation must contain an activity note for each separate transport describing the purpose for the transport, the of vehicle used for the transport, place of departure and arrival, date of service, signature of the providing staff (along with their credentials), and actual time spend providing the service by listing the start-and-stop times.

  8. Signature and Credentials • Total TripsTotal Billable TripsTotal Non-Billable Trips *District staff completes the total billable and non-billable boxes based upon dates the student receives billable services. • Driver Signature: • Driver Credential: • Bus Aide Signature: • Bus Aide Credential:

  9. Contact Information Kelley Johnson – CoordinatorOffice of Special Educationkelley.johnson@k12.wv.us304-558-2696 ext 53539WVDE Medicaid Website:https://wvde.us/special-education/Medicaid/

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