REIMBURSEMENT METHODOLOGY. School districts will be reimbursed on a Fee-For-Service (FFS) basis for specialized transportation, and additionally report eligible and allowable costs on an annual cost report. This reimbursement is part of a cost based methodology that will include a reconciled settlement. On an annual basis, a cost reconciliation and cost settlement will be processed comparing the amount of FFS interim payments to the costs reported on the annual cost report in accordance with the criteria set forth by CMS. Under the Individuals with Disabilities Education Act (IDEA), IEPs must include only specialized transportation services that a child would not otherwise receive while attending school. A child with special education needs under IDEA, who rides the standard school bus to school with children without disabilities and who does not meet all of the criteria under 3. STUDENT ELIGIBILITY CRITERIA must not have the cost of that bus ride billed to MHD as specialized transportation. School districts may submit claims for specialized transportation services to MHD using a daily one-way trip base rate with the appropriate procedure code for covered specialized transportation services. The first 10 miles of the trip are included in the daily one-way trip base rate. The daily one-way trip base rate is equal to one unit. The daily one-way trip units billed should equal the number of one-way trips for the participant for the date of service. FFS claims must follow timely filing requirements. The requirements can be referenced in Section 4 of the Therapy Manual at: xxxx://xxxxxxx.xxxxx.xxx/collections/collection_the/print.pdf. For specialized transportation services of more than 10 miles, school districts may submit claims using a mileage specific procedure code in addition to the one-way trip procedure code. School districts may bill the first 10 miles using the base rate procedure code and then bill the remaining miles of the trip using the appropriate mileage procedure code with each additional mile equal to one unit. For those services of more than 10 miles, school districts are required to indicate the pickup and drop-off locations and total miles in the child’s record. School districts may also choose to bill only the base rate code for children whose mileage exceeds 10 miles. School districts are responsible to bill Medicaid on a FFS basis throughout the school year for eligible services. Partial mileage should not be rounded up. Providers may submit claims using a medical ...
REIMBURSEMENT METHODOLOGY. The Company Entities shall pay the Capital Entities the original equipment cost ("OEC") financed by the Capital Entity less payments received by the Capital Entities, multiplied by the following percentages: if OEC is less than $300,000 - 85%; if OEC is $300,000 or more, but less than $1,000,000 - 90%; and if OEC is $1,000,000 or more - 95%.
REIMBURSEMENT METHODOLOGY. 1. Contractor will be paid on a combined administrative costs and direct services cost basis, where administrative costs must not exceed 10 percent of total expenditures and direct services costs must comprise at least 90 percent of total expenditures.
