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CMS School-Based Services Resources

We’ve also issued school-based services (SBS) guidance, most notably the 2023 Comprehensive Guide to Medicaid Services and Administrative Claiming. 

We’ve also provided sample State Plan Amendments (SPA), Time Study Implementation Plans (TSIP), Administrative Claiming Plans, and Cost Reports.

We offer states technical assistance through the Technical Assistance Center (TAC). If you have questions or feedback, please contact us at SchoolBasedServices@cms.hhs.gov.

TAC Resources

Medicaid SBS 101 Quick Guide 
Medicaid SBS Resources

  • This resource was developed for SMAs, SEAs, and LEAs, to provide a high-level overview of Medicaid SBS terms, CMS-issued guidance, and flexibilities offered to States. Additionally, a summary of resources produced by the Medicaid SBS TAC is provided.

Readiness Checklist Tool

  • This tool was developed for SMAs to help (1) draft an SBS SPA, (2) adopt certain flexibilities described in the 2023 CMS Informational Bulletin and Comprehensive Guide, (3) assess whether the State Plan reflects a payment methodology in compliance with the Comprehensive Guide, (4) prepare additional documents, such as a TSIP or Interagency Agreement for Medicaid Administrative Claiming, and (5) discuss plans for SBS with CMS and across State agencies.

Understanding Cost Pools Job Aid Resource

  • This resource was developed for LEAs to provide a high-level understanding of what cost pools are, examples of cost pools, and how an LEA would use them.

How to Answer RMTS Job Aid Resource

  • This resource was developed for LEAs to provide an explanation of the basic requirements of a Random Moment Time Study (RMTS), how school staff are notified of their participation, and best practices for answering a moment.

Medicaid SBS Federal Documentation Requirements for LEAs Resource

  • This resource was developed for LEAs to outline CMS and ED’s documentation requirements to help LEAs streamline documentation for medical service claims, cost reporting, and time studies, and comply with Federal regulations during an audit.

Reimbursement for Specialized Transportation within Medicaid SBS Resource

  • This resource was developed for SMAs, SEAs, and LEAs to outline CMS’ policy for reimbursement of specialized school-based transportation and highlight policy expressed in previous guidance.

Considerations for Developing a TSIP Resource

  • This resource was developed for SMAs and SEAs to provide considerations for elements that should be included in a TSIP to initiate SBS claiming, including treatment of the summer period, creation of the participant list, and training participants.
CMS Guidance
State SBS Examples

SBS State Plan Amendments (SPAs) using a cost methodology and expanded services beyond IDEA to any Medicaid enrolled child:

SBS SPAs using a cost methodology and IDEA services:

SBS SPAs using a cost-based rate methodology and opened expanded services for any child enrolled in Medicaid:

SBS SPAs paying the regular Medicaid fee-schedule rate for certain services: 

 Time Study Implementation Plans
Cost-Reports

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