Multi-Discipline Template (ESY & 10-Month)
Multi-Discipline Medicaid-Compliant Prescription Template for SERVICES: CLICK HERE (The Multi-Discipline Prescription Template with the "As per IEP" narrative has been removed from the Knowledge Base.
All Full-Service Medicaid counties are no longer accepting prescriptions that reference the IEP for the frequency and duration.
All 2025-26 prescriptions must show the specific frequency, duration and class designation (e.g., 2x30 Ind).
Multi-Discipline Medicaid-Compliant Prescription Template for EVALUATIONS: CLICK HERE (This Evaluation form is optional. Since evaluations are not currently handled through the Portal, you may continue to use the county's evaluation template.)
Article ID: 266, Created: 5/13/2021 at 9:45 AM, Modified: 7/2/2025 at 11:56 AM