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.
- School Corp Medicaid Reimbursement Report – State Fiscal Year 2018 Year End Data: IEP Services (pages 1-10) & MAC (last 4 pages)
Announcements, Bulletins and Topic-Specific Questions/Answers
- Medicaid Claims Announcement for Medicaid-Participating School Corporations - March 2011
- Medicaid Speech Coverage Policy Q&A
- Memo to Special Education Directors concerning Medicaid PERM audits - January 2008
- National Correct Coding Initiative Q&A
- Indiana MAC Time Study Participant Manual - Updated July 2016
- Medicaid Billing Guidebook - Updated December 2017 - The Guidebook is a high-level overview of Medicaid claiming for school-based health services and related administrative activities in Indiana.
- Medicaid Billing Tool Kit, 20th Edition – Updated December 2018 – 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 20th Edition of the Medicaid Billing Tool Kit – Updated December 2018 – The Update Log identifies what changed from the previous edition of the Medicaid Billing Tool Kit.