School-based services are health-related and rehabilitative services provided to children with disabilities who receive services under the Individuals with Disabilities Education Act (IDEA). These services are provided by school districts, charter schools, and infant toddler programs and are considered medically necessary for children to participate in their educational program.
School districts, charter schools, and infant toddler programs that enroll as Medicaid providers can receive reimbursement for school-based services provided that:
- The child is eligible for Medicaid
- Each service is specifically identified on an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP)
- Services are medically necessary for a child to benefit from their educational program
Parents/guardians are notified that the school district, charter school, or infant toddler program intends to bill Medicaid for the child’s services, and parents have the opportunity to sign a release form to have the school bill Medicaid directly for services rendered.
If schools do not wish to receive Medicaid reimbursement, they are still required to provide those services mandated by the IDEA. If a child loses Medicaid, the services that they receive through their IEP or IFSP should not be affected.
Services are determined by your child’s IEP/IFSP planning team, and must be referred by a physician or practitioner of the healing arts to determine that the services are medically necessary for Medicaid reimbursement. To find out what services are available for your child, contact your local school district.
Contact School-Based Medicaid staff by email