IHCP Updates School-Based Services Policy
In 2022, the Indiana General Assembly passed
HB 1192, which
defined "qualified provider" and "school based nurse" for purposes of providing Medicaid covered services in a school setting. It also specified conditions that must be met in order for the school based Medicaid services to be provided. (HEA 1192 digest)
Last week, Indiana Health Coverage Programs (IHCP) released a bulletin with the updated school-based services policy. The services must be medically necessary, part of the Medicaid state plan, and in a student's IEP or 504 plan. Some examples:
- Physical and occupational therapy
- Applied Behavior Analysis (ABA) therapy
- Speech/language pathology and hearing services
- Behavioral health services, including assessments and evaluations
- Mandated school nursing services by a nurse who is employed by or contracts with a school corporation
- Mandated school transportation services on dates of another covered educational plan service
Prior Authorizations - the educational program or plan serves as the Prior Authorization for the service provided.
Licensed School Psychologists - Department of Education (DoE) licensed school psychologists are qualified providers to supervise or approve services associated with a Medicaid-enrolled student's educational program or plan.
Billing - services must be billed under the National Provider Identifier (NPI) of the IHCP-enrolled school corporation, not the specific practitioner who provided services.