Medicaid Billing
Integration
How Vasl supports school-based and community health Medicaid billing ? what documentation we provide, how to access it, and what recovery to expect.
How Vasl supports Medicaid billing
Vasl does not submit Medicaid claims on your behalf. What Vasl does is generate and export the billing documentation your finance team needs to submit claims through your existing Medicaid billing system ? CPT codes, service records, provider credentials, service dates, and claim documentation formatted to meet Medicaid billing requirements.
The billing burden is yours to submit; the documentation burden is ours to generate. Your finance team reviews and submits. Vasl handles the record creation.
Monthly billing documentation exports formatted for your district's or organization's Medicaid billing system. Includes: service dates, member Medicaid eligibility indicators, CPT codes, qualified provider credentials, service type documentation, and claim-ready record formatting. Available for download from the Client Org Portal at the start of each billing cycle.
What services qualify for Medicaid billing
Not all Vasl platform activity qualifies for Medicaid reimbursement. Qualifying services are those that meet your state Medicaid program's definition of a covered behavioral health service ? typically structured, documented interactions with a qualified provider.
What qualifies for Medicaid reimbursement varies substantially by state Medicaid plan, the specific provider credential requirements in your state, and whether your organization is an enrolled Medicaid provider. Vasl provides documentation guidance and your implementation lead will model your specific recovery potential during scoping ? but the final determination of what qualifies is made by your state Medicaid program and your billing team.
The math ? what to expect
Vasl pricing has two components: a platform fee and a per member per month (PMPM) fee. For schools and non-profits, the PMPM rate is $3?5 per member per month. At the Pro plan level with 500 students, the full annual cost is approximately $38,400 ? and approximately 50% is recoverable through school-based Medicaid billing, bringing the net district cost to around $19,200/year, or roughly $38 per student per year.
The ~50% recovery figure reflects documented experience across Vasl's pilot district deployments. Your actual recovery depends on: your state's Medicaid reimbursement rates, your student population's Medicaid eligibility rate, which services your state Medicaid plan covers, and your organization's current Medicaid enrollment status. Your implementation lead will build a recovery model specific to your district during the scoping process.
Accessing billing documentation
Billing documentation is available to org administrators in the Client Org Portal. Navigate to Outcomes & Reports in the sidebar, then select Billing Documentation.
Documentation is generated monthly and available for download from the first business day of the following month. Select the month you're billing for from the period dropdown.
The export is formatted as a CSV file and a companion PDF summary. The CSV is formatted for direct import into most Medicaid billing systems. The PDF summary includes a claim-count breakdown by service type and provider credential.
Your finance team reviews the export, verifies against your student Medicaid eligibility list, and submits claims through your existing Medicaid billing system. Vasl's compliance team is available to answer questions during your first billing cycle.
Your implementation lead walks alongside your finance team through the first complete billing cycle ? answering questions, reviewing the export format, and confirming claim structure meets your state's requirements. This is included in all Vasl deployment agreements. After the first cycle, most finance teams are able to manage the process independently.
CPT code reference
The following CPT codes are used in Vasl billing documentation. Applicability depends on your state Medicaid plan and provider credential requirements. Your implementation lead will confirm which codes apply in your specific deployment during scoping.
State variation
School-based Medicaid billing operates under federal Medicaid guidelines but is administered by each state ? which means reimbursement rates, qualified provider definitions, and covered service types vary significantly. Some states have robust school-based behavioral health billing infrastructure. Others have more limited programs.
Key state-specific factors that affect your recovery potential: whether your state's Medicaid plan covers community behavioral health services delivered outside a clinical setting; the provider credential requirements for reimbursable services (some states require LCSW or higher; others permit certified coaches under supervision); your state's per-unit reimbursement rate for behavioral health services; and whether your organization is currently an enrolled Medicaid provider.
Vasl's compliance team has worked with districts and organizations across multiple states and can provide state-specific guidance during your implementation scoping. Contact billing@vaslhealth.com with your state to start that conversation.
Additional funding mechanisms
Beyond Medicaid, Vasl deployments may be fundable through several additional mechanisms depending on your organization type:
Vasl provides a grant documentation package for partner organizations applying for additional funding ? including IRB study protocol, pilot outcome data, VLAP technical overview, and compliance documentation. Contact billing@vaslhealth.com to request the package.