School-Based Medicaid

Posted: Fri, 09/23/2011 - 3:18pm Updated: Tue, 03/22/2016 - 3:00pm

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


  • 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, Fifteenth Edition - Updated November 2014 - 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 15th Edition of the Medicaid Billing Tool Kit - Updated November 2014 – See the Update Log to identify what’s new in the latest edition of the Medicaid Billing Tool Kit; follow the Update Log instructions to add and remove pages from your paper copy of the Tool Kit.

Sample Forms and Parent Information Sheets