All providers who receive federal funds from HHS for the provision of Medicaid/CHIP services are obligated to make language services available to those with Limited English Proficiency (LEP) under Title VI of the Civil Rights Act and Section 504 of the Rehab Act of 1973. However, language interpretation services are not classified as mandatory 1905 services.
States are not required to reimburse providers for the cost of language services, nor are they required to claim related costs to Medicaid/CHIP. States may consider the cost of language services to be included in the regular rate of reimbursement for the underlying direct service. In those cases, Medicaid/CHIP providers are still obligated to provide language services to those with LEP and bear the costs for doing so. Still, states do have the option to claim Medicaid reimbursement for the cost of interpretation services, either as medical-assistance related expenditures or as administration.
Claiming Administrative Match For Translation/Interpreter Services
Longstanding CMS policy permits reimbursement at the standard 50% federal matching rate for translation/interpretation activities that are claimed as an administrative expense, so long as they are not included and paid for as part of the rate for direct services.
With the enactment of Section 201(b) of the Children’s Health Insurance Program Reauthorization Act (CHIPRA, Public Law 111-3) on February 4, 2009, states were given the option to claim a higher matching rate for translation/interpretation services (75% under Medicaid; 75% or the state's enhanced FMAP + 5%, whichever is higher, under CHIP, subject to the 10% statutory limit on CHIP administration) that are claimed as administration and are related to enrollment, retention and use of services under Medicaid and CHIP for certain populations.\
The intent of the CHIPRA provision is to encourage the provision of translation and interpretation services to qualifying individuals with LEP. Eliminating language barriers is one key component of a broader strategy for promoting better access to coverage and care. This increased translation/interpretation matching rate is an important new source of Federal support to help states eliminate these barriers.
The increased CHIPRA matching rate is available for translation and interpretation services provided to “children of families for whom English is not their primary language,” and family members of these children. Expenditures associated with the provision of translation and interpretation services to Medicaid enrollees that do not fit into this category are still reimbursable at the standard 50 percent Medicaid administrative matching rate, or as part of the rate paid for a medical service.
Claiming FMAP For Translation/Interpreter Services
Interpreters are not Medicaid qualified providers; however their services may be reimbursed when billed by a qualified provider rendering a Medicaid covered service. Interpreters may not be paid separately. As of February 2009, oral interpreter services can be claimed using billing code T-1013 code along with the CPT Code used for the regular medical encounter. States can also raise rates to recognize additional service costs, including interpreter costs, but must do so for services rendered by all providers in the class.