School-Based Medicaid

Federal law expressly ensures that Medicaid reimbursement is available for health-related services which schools must provide to meet the educational needs of a student with a disability. By law, Medicaid claiming for school-based services in a student’s Individualized Education Program (IEP) cannot affect the student’s Medicaid eligibility or benefits.

Approximately 125 public school corporations in Indiana bill Medicaid for covered IEP services (such as physical therapy, nursing and audiology) subject to parental consent; and the resulting federal funds help local schools finance services, equipment, supplies, professional development and specialized training as required by the federal Special Education mandate.

General Information

• Indiana Medicaid Helps Schools Cover the Cost of Some Health Care Services in Student IEPs
• Medicaid in Schools Newsletters
• School Corp. Medicaid Report-1st Half SFY 2013: IEP& MAC reimbursements per LEA at Tabs 1-3

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

Manuals

• Indiana MAC Time Study Participant Manual - Updated December 2011
• Medicaid Billing Guidebook - Updated July 2011 - The Guidebook is a general overview to orient schools to the Medicaid program in general and to billing Medicaid for health-related services schools provide to students with Individualized Education Programs (IEPs).
• Medicaid Billing Tool Kit, Thirteenth Edition - Updated February 2013 - 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 and Updated Pages Only: Medicaid Billing Tool Kit, Thirteenth Edition Updated February 2013 - Follow the instructions on the Update Log to add and remove pages from your paper copy of the Tool Kit.

Sample Forms and Parent Information Sheets

• Request for Consent to Bill Medicaid - English
• Request for Consent to Bill Medicaid - Spanish
• School-Based Medicaid Billing - Parent Brochure
• School-Based Medicaid Billing - Parent Brochure - Spanish

Presentations

• Archive of School-Based Medicaid-Related Presentations