What is NH Medicaid to Schools?

The NH Medicaid to Schools program gives local education agencies (LEAs) and school administrative units (SAUs) the opportunity to obtain federal Medicaid dollars for eligible services. Medicaid dollars offset the cost to schools of delivering Medicaid-covered services.

New Hampshire’s Medicaid to School (He-W 589) rule went into effect in February 2020, describing Medicaid-reimbursable services provided by NH school districts and administrative units. Engagement in the Medicaid to Schools Program offers an opportunity for reimbursement for services that schools are required to provide based on Individualized Education Plans (IEPs), as well as other services for Medicaid-eligible students.

Who is eligible?

A student who meets all of the following criteria is eligible to have their services billed to Medicaid:

checkbox iconIs less than 21 years of age;

checkbox icon Is a Medicaid recipient;

checkbox iconIs served by a local education agency (LEA) or school administration unit (SAU) that is an NH Medicaid enrolled school provider (He-W 589.03(a)-(d)); and

checkbox iconHas a care plan.

Additionally, the parents of a student whose services are billed through Medicaid must give consent for this billing process to happen. This parental consent is typically received during the Individualized Education Plan (IEP) process.

What types of services may be covered by Medicaid to Schools?

  • Occupational therapy
  • Physical therapy Speech/language therapy
  • Nursing
  • Audiology
  • Vision
  • Applied behavior analysis
  • Rehabilitative assistance
  • Psychological and mental health services
  • Specialized transportation

Receiving services in the school setting does not limit a child’s eligibility to receive services outside of school. As long as both services are considered medically necessary and meet Federal Medicaid law children can receive services through school that are paid for by Medicaid to Schools and traditional Medicaid.

A more comprehensive outline of covered services can be found in the Medicaid to Schools Technical Assistance Guide.

Have more questions?

We are available to answer any questions about the program.