School-Based Medicaid Services

///School-Based Medicaid Services
School-Based Medicaid Services2018-04-17T09:42:55+00:00

Medicaid and school districts may work together to provide services to students with disabilities. The Individuals with Disabilities Education Act (IDEA) ensures children with disabilities are provided with a free and appropriate public education (FAPE). Students with disabilities are placed in an Individual Education Program (IEP) to identify the specific services needed by that student.

Senate Report 94-168, 1975, allows school districts to use other funding sources, such as Medicaid, to assist in the implementation of these services. In 1993, Idaho Medicaid worked with the Idaho Department of Education to facilitate rules for school districts to access federal Medicaid funding for those health-related services that are identified in the IEP. 


If your child is Medicaid eligible, your school district must get your consent to release identifiable information from your child’s IEP when claims are sent to Medicaid. Your student’s information is protected under the Family Educational Rights and Privacy Act (FERPA).

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, and charter schools and are considered medically necessary for children to participate in their educational program. 

School districts and charter schools 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)
  • Services are medically necessary for a child to benefit from their educational program

Parents/guardians are notified that the school district or charter school 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 should not be affected. 

health and welfare department

For more information, please visit the Idaho Department of Health and Welfare or contact Special Education Director Nicole Elliott.
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