School-Based Medicaid

Posted: Fri, 09/23/2011 - 3:18pm Updated: Thu, 06/30/2016 - 2:26pm

Federal law makes Medicaid reimbursement available for health-related services that schools provide to meet the educational needs of students with disabilities. By law, Medicaid claiming for Individualized Education Program (IEP) services cannot affect the student’s Medicaid eligibility or benefits. Approximately 140 Indiana public school corporations claim Medicaid reimbursement for covered IEP services (such as physical therapy, nursing and audiology) subject to parental consent. Additionally, nearly 100 public school corporations participate in school-based Medicaid Administrative Claiming to recover costs of administrative activities that school staff perform to help address students’ unmet healthcare needs. Federal Medicaid funds from both programs help local schools defray costs associated with administrative activities as well as equipment, supplies, professional development and specialized training required to comply with the federal Special Education mandate.

General Information

Announcements, Bulletins and Topic-Specific Questions/Answers

Manuals

  • Indiana MAC Time Study Participant Manual - Updated October 2014
  • Medicaid Billing Guidebook - Updated April 2015 - The Guidebook is a high-level overview intended to orient school personnel to the Medicaid program and to general concepts involved in Medicaid claiming for school-based health services and related administrative activities.
  • Medicaid Billing Tool Kit, Sixteenth Edition - Updated July 2016 – The Tool Kit discusses Indiana Medicaid billing requirements for covered health-related services in a student’s IEP. It includes general billing guidelines for all IEP services, as well as coverage limitations, Medicaid provider qualifications and other billing details applicable to each type of Medicaid-covered IEP service.
  • Update Log for the 16th Edition of the Medicaid Billing Tool Kit - Updated July 2016 – See the Update Log to identify what has changed in the latest edition of the Medicaid Billing Tool Kit.

Sample Forms and Parent Information Sheets

Presentations