Medicaid Payment for School-Based Services

Speech-language pathologists and audiologists express concerns about the proper billing of Medicaid for their services provided to children in schools. The following information and resources were developed to provide information related to Medicaid payment for school-based services.

Frequently Asked Questions

These FAQs about audiology and speech-language pathology Medicaid services provided in the schools were developed in conjuction with ASHA's School Finance Committee .

• The School's Role
• The Audiologist's and SLP's Role
• Eligibility, Billing, and Submitting Claims

Facts Related to Medicaid Billing by Schools

• In 2002, schools in 45 states and the District of Columbia billed for Medicaid services, while schools in 17 states billed for administrative expenditures. (Not all school districts in a state necessarily participate in Medicaid billing.)
• In 2001, Medicaid covered 49.7% of all U.S. children.
• Most school districts pay private firms for assistance in processing Medicaid claims, but these fees are not allowable for federal reimbursement.
• Health services in schools in 2003 represented less than 0.8% of all Medicaid spending (Schools = $2.13 billion).
• ASHA supports provider standards for school-based Medicaid services that are equivalent to ASHA certification.

Additional Resources

• Medicaid and Third Party Payments in the Schools
• FAQs - General Medicaid Information
• IDEA/Medicaid Side-By-Side for Audiology and Speech-Language Pathology Services
• Questions? Contact reimbursement@asha.org.