Medicaid Reimbursement for IEP Services

IN Medicaid-covered IEP Services

IEP-required R.N. services and Special Ed Transportation Just added:

What documentation is required? Documentation that a direct medical service was provided to an eligible Special Education student e.g., paper or electronic Service Log; Student Record Medical Necessity Documentation e.g., physician order; assessments; treatment plan/IHP General School Corporation Records e.g., financial; student & staff attendance; licensure Details online in the Medicaid Billing Tool Kit

Watch for Tool Kit Updates

There must be an order or referral for therapy and nursing services that are billed to Medicaid. The School Psychologist practice act, IC , defines “School Psychology” to include referring a student to: “(A) a speech-language pathologist or an audiologist licensed under IC for services for speech, hearing, and language disorders; or (B) an occupational therapist licensed under IC for occupational therapy services” Required Referral for Medicaid- reimbursed IEP Services

How does reimbursement work? Every Medicaid check = state + federal funds –At present: each Medicaid payment includes 75% federal & 25% state dollars –State funds “draw down” additional federal $ –Medicaid-participating school corporations recover a portion of their costs for providing Medicaid-covered health-related services to students with an Individualized Education Program (IEP)

Medicaid reimbursement example

How Many School Corps Bill? In Fiscal Year 2009: 71 In Fiscal Year 2010: 110

Which Corporations Participate?

What resources are available? The Medicaid Billing Tool Kit & Guide Presentations, bulletins, reports Articles, Q&A, Newsletters Sample Forms Parent Information Brochure VISIT:

IDOE’s Medicaid Web Page

National Resources on School- based Medicaid Services