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Technical Assistance Materials

To support State Medicaid agencies, LEAs, and school-based entities in providing and improving the delivery of covered Medicaid and Children’s Health Insurance Program (CHIP) services to enrolled students in school-based settings, CMS is providing links to sample State Plan Amendments, Time Study Implementation Plans, Administrative Claiming Plans, and Cost-Reports.

These are good examples of what a handful of States have done in implementing their school-based services programs. Some of these examples are older and may not be in full compliance with the latest CMS guidance from the 2023 Delivering Services in School-Based Settings: A Comprehensive Guide to Medicaid Services and Administrative Claiming.

State Plan Amendments (SPAs)

SBS SPAs using a cost methodology and opened “Free Care” services:

SBS SPAs using a cost methodology and IDEA services:

SBS SPAs using a cost-based rate methodology and opened “Free Care” services:

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

Free Care SPAs:

IDEA only SPAs:

Time Study Implementation Plans


Please contact us if you would like any technical assistance in developing your cost report. 

Here are some State Medicaid Program links for Medicaid and School-Based Services (there are examples of provider manuals, cost reports, and other items that may be useful to other States):

Disclaimer: This United States Government website contains links to non-United States Government websites. We are providing these links because they contain additional information and resources relevant to the topic(s) discussed in this website on Medicaid and School-Based Services or that otherwise may be useful to the reader. We cannot attest to the accuracy of information provided on the cited third-party websites or any other linked third-party site. We are providing these links for reference only; linking to a non-United States Government website does not constitute an endorsement by CMS, HHS, or any of their employees of the sponsors or the information and/or any products presented on the website. Also, please be aware that the privacy protections generally provided by United States Government websites do not apply to third-party sites.

In addition to the linked examples here are links to policy papers and resources:

Contact Us

CMS is available to provide technical assistance to States to best implement their programs. If you have questions regarding implementation of these options, please contact CMS at: SchoolBasedServices@cms.hhs.gov