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May 26, 2023

CMS Releases Comprehensive Guide to Medicaid Services and Administrative Claiming for School-Based Services

On May 18, 2023, CMS issued a comprehensive guidance document that provides detailed instructions on payment mechanisms, billing processes, and enrollment for qualified health care providers to participate in Medicaid within school settings. CMS’s primary goal of the newly issued guidance is to enhance access to Medicaid health care services in schools, including behavioral health services, while also reducing administrative burdens for states and schools. The guide introduces new flexibilities and consolidates existing guidance to simplify the payment process for Medicaid-covered services in schools of all sizes. By implementing the suggested flexibilities, states can significantly alleviate administrative burdens for schools, making it more convenient to receive payment for health services provided to children enrolled in Medicaid and CHIP.

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