Reimbursement Explained
A U.S. Department of Education document explaining Medicaid funding for school-based services indicates the funding increases access to quality physical, mental and behavioral health services for eligible students such as students with disabilities served under the Individuals with Disabilities Education Act (IDEA) and students from low-income families enrolled in Medicaid or CHIP programs. Most states have Medicaid plans in place allowing for Medic-
aid reimbursement for health services provided to students with disabilities under IDEA. Making health services available in schools for all Medicaid-enrolled students can significantly increase the number of students accessing them and reduce families’ burdens, the DOE notes, adding students are six times more likely to access mental health care when these services are offered in school. The federal government established general rules that all state Medicaid programs must follow, with eligibility requirements and benefits varying from state to state. However, The U.S. DOE document indicates only 16 states have plans allowing for the reimbursement of services to Medicaid-eligible students beyond those who receive services under IDEA. States with approved plans providing for reimbursement of school-based services to all Medicaid-enrolled students include Arizona, California, Colorado, Illinois, Kentucky, Louisiana, Massa- chusetts, Michigan, Nevada, New Mexico, North Carolina, Oregon, and Virginia. States with approved plans that provide for reim- bursement of some school-based services or for some students beyond those with Individual Education Programs (IEP) who are enrolled in Medicaid include Connecticut, Georgia and Indiana. The DOE notes that having a state plan allows reimbursement
for services to all Medicaid-enrolled students. A state’s educational and State Medicaid Agency (SMA) can
review the most recent state plan approved by the Centers for Medicare & Medicaid Services (CMS) related to school-based services and discuss needed changes to expand school-based Medicaid reimbursement for all Medicaid eligible students. View the 2023 Comprehensive Guide to Medicaid Services and Adminis- trative Claiming,
stnonline.com/go/ob. The SMA can file a State Plan Amendment (SPA) with CMS doc- umenting the state’s decisions about the kinds of school-based services that can be reimbursed and requirements for the profes- sionals that may provide such services. More information is at CMS Medicaid SPA Toolkit,
stnonline.com/go/o7. Working with the federal Medicaid and School Based Services
Technical Assistance Center ensures efficient delivery of and reimbursement for school-based services, shares resources with the local educational agency and learning how other states are creating best practices while expanding school-based services. The CMS Medicaid School-Based Services Technical Assistance
Center is available to support state Medicaid agencies, state edu- cational agencies, and local education agencies in operationalizing Medicaid SBS. A list of frequently asked questions with the latest updates can be found at
stnonline.com/go/o8.
24 School Transportation News • JANUARY 2026
all Medicaid reimbursements are handled by districts without the company’s involvement. Campbell Millum, HopSkipDrive senior vice president for communication and external affairs, said her company partners with school districts nationwide to facilitate rides for qual- ified students. Districts handle selecting and, if needed, filing for reimbursements from relevant funding streams, including Medicaid. She said HopSkipDrive recognizes that nav-
igating various funding avenues, including Medicaid reimbursement, can be a complex administrative task for districts already manag- ing many critical responsibilities. “Our goal is to be a supportive partner in this,” she added. “As a technology company, we aim to help our district partners ensure their trans- portation solutions are cost-effective, efficient and, most importantly, safe.” As a supplemental transportation partner,
the company defers to district teams on the best funding sources for their specific needs, Millum said. HopSkipDrive’s RideIQ ride man- agement platform is designed to help make the reimbursement process as straightforward as possible for district staff. “By providing specific mileage and service
information, RideIQ enables districts to quickly generate the detailed, accurate reports neces- sary to apply for and receive funding they are entitled to,” she added. The company’s client services team helps
districts navigate data and provide necessary in- sights to help districts fully leverage the platform.
Technology to the Rescue Sonia Mastros, the president of Orbit Software, said many districts forego Medicaid transpor- tation reimbursement because they cannot produce documentation to support the claim. “Transporting students who receive special
education services is expensive,” she said. “Yet reimbursement often depends on clear, defen- sible records of who was transported, when and for what purpose. States differ in their rules, but auditors expect accuracy. Paper logs and manu- al spreadsheets rarely meet that standard.” This is where she sees modern routing and tracking systems being a benefit. “The right software gives districts the data needed to doc- ument eligibility, verify each trip and support claims with confidence,” she said. “This reduces
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