School Based Medicaid Services

Published: 2/10/2016 1:35 PM

Kentucky school districts may participate in two Medicaid School-Based Programs.  School-Based Health Services and School-Based Administrative Claiming.

School-Based Health Services (SBHS)

The School-Based Health Services (SBHS) program authorizes local education agencies in Kentucky, including KSB and KSD to enroll as a Medicaid Health service provider for children who are eligible under the Medicaid program and under the Individuals with Disabilities Education Act(IDEA).  The Medicaid SBHS program is designed specifically to allow school districts to act as health care providers and be reimbursed under Medicaid.  School districts may be reimbursed approximately 70 percent of the state and local funds they spend on some related services in the individualized education programs (IEP) of children with disabilities who are eligible under both IDEA and Medicaid.

SBHS Technical Guide revised 02/10/2016


Parental Consent and Annual Notification Letters

Spanish version of Parental Consent and Annual Notification Letters.

Parental Consent and Annual Notification Letters--Spanish

This FAQ document should address the concerns regarding Medical Necessity in the IEP and the Transportation issues. 
Application Process
The School-Based Health Services application must be submitted annually.  The Department for Medicaid Services will not honor any claims until the application has been approved by KDE.
SBHS Application Instructions

Amending the Application

The amendment form must be submitted to make changes to the approved practitioner list.  The form adds staff or deletes staff and services to the district's approved application.
 SBHS Amendment Form
Release of Information (forms must be signed annually by parents of Medicaid eligible students.)



2015 School Based Medicaid Annual Meeting

August 24 & 25, 2015

Presentations - Please print or download to personal devices.

Agenda for KDE Annual Meeting

Introduction to School-Based Medicaid 101

HP Presentation School Based Services 2015

Kentucky Cost Reporting and Monitoring

School Based Administrative Claiming_SSG

Payment Error Rate Measurement (PERM) for SBHS 08-10-2015




2014 School Based Medicaid Annual Meeting

July 31 and August 1, 2014
Presentations - please print or download to personal devices.
Denise Bailey Recorded Presentation:  Documentation for School-based Medica. . . - Jul 23 2014
Denise Bailey PowerPoint:  Medicaid 2014 Summit DB- PDF

2013 School-Based Medicaid Conference Presentations

Medicaid/KDE Fraud Presentation

Physical Therapy Presentation

Speech Therapy Presentation

Nursing Services & Medicaid in the School Setting

   Nursing Form Examples

School Based Services the Unique Partnership of Medicaid and Education

School-Based Occupational Therapy Services

PCG, Inc. SBAC Presentation

Fairbanks, LLC Cost Report Presentation



School-Based Administrative Claiming (SBAC)

The Medicaid School-based Administrative Claiming (SBAC) program reimburse school districts for the time employees spend in administrative activities that directly support efforts to identify and enroll potentially eligible children and their families into Medicaid.  SBAC involves all school district staff who, as part of their routine job duties, help students and their families learn about Medicaid, apply for Medicaid benefits, refer students to community medical and mental health providers or collaborate with other school staff or community agencies to better address the health care needs of students.

 School Based Administrative Claiming Technical Assistance Document approved by CMS

 SBAC MUNIS Instructional Guide revised 02/2016/


The following are new instructions and templates for submitting the calendar and work schedule for the upcoming school year to Sivic Solutions Group (SSG).  This information is due to SSG by August 15, 2014.

KY SBAC Instructions for Calendar and Work Schedule

Calendar_Template 2015-2016

WorkSchedule_Template 2015-2016


School_Listing Codes for RMTS Site


 Below is the PowerPoint for SBAC Training for both the Coordinators and the Participants.  Please download for the Training sessions.
Below is the PowerPoint for the SBAC Training for the Cost ReportThe trainings were held the week of January 13-16, 2015.




Becky Stoddard
Office of Administration and Support
Division of Budget and Financial Management
500 Mero Street, 16th Floor CPT
Frankfort, KY 40601
(502) 564-1979
Fax (502) 564-6771