Ordered byan EnrolledPractitionerDate andTime ofServiceDiagnosticStatementand Purposeof TreatmentPsychologicalEvaluationsCoveredinMedicaidPlanPsychologicalCounselingFree ofChargeServicesOT andPT on thesame dayPhysician’sorderAudiologicalEvaluationsNoSupervisionRequirementsTwo differentOT Sessionsand One is aMakeupSessionTwo DifferentPt Sessionsand One is aMakeupSessionMedicalSpecialistEvaluationsEnrolledinMedicaidSpecialTransportationServicesOccupationalTherapy3-20yearsoldPhysicalTherapyPrior totreatmentQualifiedMedicaidproviderGroupSizeGroup orIndividualDescriptionofProgressSkilledNursingServicesSpeechTherapyServicesListedon IEPDocumentationRequirementsMedicalEvaluationsName, Title,Signature,andCredentialsof ClinicianStudent’sNameMedicaidType ofServiceProviderRequirementsMedicallyNecessarySignatureSupervisingClinicianOrdered byan EnrolledPractitionerDate andTime ofServiceDiagnosticStatementand Purposeof TreatmentPsychologicalEvaluationsCoveredinMedicaidPlanPsychologicalCounselingFree ofChargeServicesOT andPT on thesame dayPhysician’sorderAudiologicalEvaluationsNoSupervisionRequirementsTwo differentOT Sessionsand One is aMakeupSessionTwo DifferentPt Sessionsand One is aMakeupSessionMedicalSpecialistEvaluationsEnrolledinMedicaidSpecialTransportationServicesOccupationalTherapy3-20yearsoldPhysicalTherapyPrior totreatmentQualifiedMedicaidproviderGroupSizeGroup orIndividualDescriptionofProgressSkilledNursingServicesSpeechTherapyServicesListedon IEPDocumentationRequirementsMedicalEvaluationsName, Title,Signature,andCredentialsof ClinicianStudent’sNameMedicaidType ofServiceProviderRequirementsMedicallyNecessarySignatureSupervisingClinician

Untitled Bingo - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Ordered by an Enrolled Practitioner
  2. Date and Time of Service
  3. Diagnostic Statement and Purpose of Treatment
  4. Psychological Evaluations
  5. Covered in Medicaid Plan
  6. Psychological Counseling
  7. Free of Charge Services
  8. OT and PT on the same day
  9. Physician’s order
  10. Audiological Evaluations
  11. No
  12. Supervision Requirements
  13. Two different OT Sessions and One is a Makeup Session
  14. Two Different Pt Sessions and One is a Makeup Session
  15. Medical Specialist Evaluations
  16. Enrolled in Medicaid
  17. Special Transportation Services
  18. Occupational Therapy
  19. 3-20 years old
  20. Physical Therapy
  21. Prior to treatment
  22. Qualified Medicaid provider
  23. Group Size
  24. Group or Individual
  25. Description of Progress
  26. Skilled Nursing Services
  27. Speech Therapy Services
  28. Listed on IEP
  29. Documentation Requirements
  30. Medical Evaluations
  31. Name, Title, Signature, and Credentials of Clinician
  32. Student’s Name
  33. Medicaid
  34. Type of Service
  35. Provider Requirements
  36. Medically Necessary
  37. Signature Supervising Clinician