MedicaidAdministrativeMedium impact
ForwardHealth Update 2026-10: Additional School-Based Services Changes
Wisconsin ForwardHealth·WI · Physical Therapy, Occupational Therapy, Pediatrics +1 more·Provider Update
Effective date
Jul 1, 2026
We identified it
Jun 18, 2026
Summary
ForwardHealth (Wisconsin Medicaid) now requires individual NPIs (Type 1) from prescribing/referring/ordering providers on certain school-based services claims, implements stricter time study requirements, and narrows specialized transportation coverage to only physically modified vehicles.
Action Required
By July 1, 2026: School-based services providers must ensure individual NPIs (Type 1) are included on claims for nursing services, occupational therapy, physical therapy, speech-language pathology, and attendant care services. Billing team must update claim submission procedures to include prescribing/referring/ordering provider's individual NPI or claims will be denied. Update time study procedures to accommodate 2-day notice periods and 2-day response windows instead of 5 days. Review specialized transportation billing to ensure only physically modified vehicles are billed as specialized transportation.