Medicaid Reimbursement for School Nursing Services
June 5, 2019
Overview
This fact sheet provides examples of ways that states have chosen to address Medicaid billing for school nursing, highlighting the need for states to consider expanding Medicaid coverage for school nursing services by amending state laws.
Medicaid is a significant payer for child and adolescent health care in the United States, covering 36 percent of school aged children. School nursing is an important resource for school children to access health care and preventive health services, yet few state laws specifically provide for Medicaid coverage for school nursing services not provided in accordance with a student’s Individual Education Plan (IEP).
School nurses provide a broad scope of services ranging from administering screening tests, managing chronic conditions, and educating children about healthy lifestyle choices, to handling life-threatening allergy and asthma events. For many children, the school nurse may be the only health care provider they will see all year. Because school nurses are trained to understand the complexity of the relationship between physical and emotional well-being and academic success, they play a unique and valuable role in ensuring that students are healthy and able to learn.
Medicaid Reimbursement for School Nursing Services
This fact sheet provides examples of ways that states have chosen to address Medicaid billing for school nursing, highlighting the need for states to consider expanding Medicaid coverage for school nursing services by amending state laws.
