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For School Administrators & District Leaders

Stop losing $150K–$300K annually in unbilled Medicaid services.

Federal law authorizes schools to bill Medicaid for mental health services provided to eligible students—but many districts never capture this revenue. CodePause® Terminal EMR recovers lost revenue while training your entire staff to reduce escalations, police calls, and outside agency involvement.

$150K–$300K
Typical annual Medicaid billing lost
42 USC §1396
Federal authority for school billing
National Standard
Crisis training certification

The true cost of inadequate crisis systems

Districts lose hundreds of thousands in unbilled Medicaid services while escalating crises strain staff, drain budgets, and damage school climate.

Money left on the table:

Unbilled Medicaid mental health services

Federal law (42 USC §1396, EPSDT mandate) authorizes schools to bill Medicaid for counseling, therapy sessions, and case management provided to eligible students—but most districts never submit claims due to documentation gaps

Mental health services never captured

Federal law authorizes schools to bill Medicaid for mental health services provided to eligible students—yet many districts still don't claim hundreds of thousands annually because existing systems can't generate compliant claims

Staff time wasted on non-billable documentation

School counselors and psychologists spend hours documenting interventions in formats that don't meet Medicaid billing standards—working for free instead of recovering costs

Escalation & compliance failures:

Untrained staff escalating crises

Teachers, administrators, and support staff handle behavioral health crises without formal training—turning manageable situations into suspensions, expulsions, and police calls

Law enforcement as default crisis response

Crisis calls go to campus police or 911 instead of licensed mental health professionals—creating legal exposure, traumatizing students, and damaging district reputation

Outside agency involvement

Inadequate crisis response leads to CPS investigations, psychiatric hospitalizations, and court proceedings—each costing thousands in legal fees and lost enrollment funding

IDEA & FERPA compliance gaps

Crisis documentation doesn't meet IDEA requirements or FERPA standards—audit findings, parental complaints, and denied Medicaid claims compound financial losses

Federal Legal Authority for School-Based Medicaid Billing

42 USC §1396 (Social Security Act Title XIX): Establishes Medicaid coverage for medically necessary services, including mental health crisis interventions provided by schools
42 USC §1396d(r) (EPSDT): Early and Periodic Screening, Diagnostic and Treatment mandate covers comprehensive mental health services for children under 21
20 USC §1411-1419 (IDEA Part B): Requires schools to provide psychological services as "related services" and permits Medicaid billing for these federally mandated services
2014 CMS Policy Clarification: Federal policy allows schools to bill Medicaid for covered services to all Medicaid-enrolled students (state adoption varies—some states still limit to IEP/IFSP services)

Recover lost revenue + reduce escalations with CodePause® Terminal

Purpose-built EMR that generates clean Medicaid claims for crisis services while training your entire staff to de-escalate before situations spiral.

Crisis Training Certification for All Staff

National standard
  • Teachers, administrators, support staff—not just counselors—learn behavioral health crisis de-escalation techniques specific to school environments
  • Clear decision protocols—when to handle internally vs. engage CodePause crisis line vs. call emergency services, reducing inappropriate police involvement
  • Certification as professional development—demonstrable staff training that satisfies IDEA compliance requirements and reduces liability exposure
  • Measurable escalation reduction—track suspension/expulsion rates, law enforcement calls, CPS referrals before and after certification to quantify impact

24/7 Licensed Crisis Response

Immediate telephonic access
  • Phone access to LCSWs and LMHCs—students and staff connect instantly with licensed crisis counselors who de-escalate situations telephonically
  • Real-time coordination with school counselors—crisis counselors notify district mental health staff immediately, share safety plans, and coordinate next-day follow-up
  • Replaces police as first response—trained mental health professionals handle behavioral crises, reserving law enforcement for actual safety threats, not mental health episodes
  • Billable to Medicaid and insurance—crisis interventions generate revenue under existing codes (H0018, H2011) instead of being unfunded cost centers

Medicaid Billing Recovery System

Clean claims generation
  • Structured documentation for crisis services—CodePause® Terminal captures every required data element for Medicaid claims (diagnosis, service codes, duration, provider credentials)
  • IEP/IFSP Medicaid billing—automatically generates claims for mental health services in student IEPs, recovering $200K-$500K annually per district that existing systems miss
  • Integrated clearinghouse—Terminal submits claims directly to state Medicaid programs and commercial payers, accelerating reimbursement cycles and reducing admin burden
  • State-specific compliance—pre-configured for each state's Medicaid program rules, billing codes, and documentation requirements (varies by state)

FERPA & IDEA Compliant Documentation

Audit-ready records
  • FERPA-compliant crisis records—proper access controls, parental consent workflows, and disclosure logs that protect student privacy while enabling crisis coordination
  • IDEA-compliant psychological services—documentation meets "related services" standards for IEP services, satisfying federal audit requirements and state education department reviews
  • Safety plan integration—crisis counselors access student safety plans with appropriate consent, ensuring interventions align with existing treatment plans
  • Outcome tracking for grants—validated outcome measures demonstrate crisis program effectiveness for state grants, federal funding applications, and board reporting
$150K-$300K recovered annually
Typical Medicaid billing capture
30-50% escalation reduction
Suspensions, police calls, CPS referrals
IDEA & FERPA compliant
Audit-ready crisis documentation
Whole-staff training
Teachers, admin, support—not just counselors

Built for your district's unique needs

K-12 School Districts

You serve diverse student populations with significant Medicaid eligibility and frequent behavioral crises. CodePause® Terminal was designed for this.

Perfect for:
• Title I schools with high Medicaid enrollment
• Districts reducing suspension/expulsion rates
• Schools decreasing law enforcement involvement

Higher Education Institutions

Campus counseling centers overwhelmed by demand need 24/7 crisis access that doesn't route to police by default.

Perfect for:
• Universities with weeks-long waitlists
• Colleges reducing psychiatric hospitalizations
• Campuses improving student retention

Alternative & Special Education

Students with complex behavioral health needs require specialized crisis protocols and meticulous IDEA-compliant documentation.

Perfect for:
• Therapeutic day schools
• Residential treatment programs with education
• SPED-focused districts with high IEP rates

Join the Pilot Waitlist

School districts will pilot CodePause® Terminal at founding pricing. Priority onboarding for early partners who want to recover lost Medicaid revenue and train staff to reduce escalations.

Questions about Medicaid billing or staff training? Contact our school partnerships team