IEP based Services and Medicaid Reimbursements

by Lisa Waterman

Most of us have heard about the Medicare and Medicaid programs.  Medicare is used by those over the age of 65 to help with healthcare related costs.  Medicaid provides free or low-cost health coverage to millions of Americans, including low-income people and families with children.    A simple search for Medicaid related bills being considered in Helena currently results in a long list including multiple revisions and changes to the current program.   The state is also looking at increasing funding for mental health services in schools which include Comprehensive School and Community Treatment or CSCT programs.
Not only does Medicaid help low-income families in Montana receive needed healthcare, school districts and special education cooperatives have the ability to also receive Medicaid dollars for eligible students and services.  The direct care services must be IEP driven and a guardian for the student must also sign a consent to bill Medicaid form before claims to DPHHS can be submitted.  Services available to schools for Medicaid reimbursement include speech therapy, occupational therapy, physical therapy, mental health, personal care services, nursing services, and select evaluations for these service types.  

We will continue to watch the Montana legislature for changes to the Medicaid program.  As of now, the legislative process is indicating that Medicaid expansion is likely to continue in the state.  Of course, things can change at the national level especially during these dynamic times, but the Medicaid program available for children from low-income families is expected to continue.  Visit DPHHS for more information about School Based Services and Medicaid.

If you are interested in learning more about how School Services of Montana's Medicaid Billing Program can support you in this process, contact Lisa Waterman, Medicaid Billing Program Manager.