Effective October 1, 2021, the Medicaid School Based Claiming (MSBC) program will cover all Medicaid-enrolled children in participating Local Education Agencies (school districts). This change recognizes the growing need to provide medical and behavioral health services and support to children where they spend the majority of their time—in school.
With this change, Local Education Agencies will have more flexibility in their school-based Medicaid programs by allowing school districts to bill Medicaid for medical or behavioral health services delivered to all Medicaid-enrolled children, not just those with a special education plan documented by an Individualized Education Plan (IEP). AHCCCS will also add specialty providers to the program in order to better serve students in schools.
Those Medicaid covered services can be delivered to Medicaid enrolled students that require medical or behavioral health services identified as medically necessary in an IEP, Individualized Family Service Plan (IFSP), 504 Plan, other individualized health or behavioral health plan, or where medical necessity has otherwise been established. .
To learn more see the AHCCCS Medicaid School Based Claiming Program web page.