Medicaid to Schools

Medicaid to Schools is a benefit of the NH Medicaid state plan that offers local education agencies and school administrative units the opportunity to receive federal Medicaid dollars to offset costs for Medicaid covered services performed by qualified medical or behavioral health treatment providers in a school setting to a NH Medicaid eligible student.

Medicaid to Schools (MTS) Training and Technical Assistance Resource

The New Hampshire Department of Health and Human Services (DHHS) is pleased to announce that the JSI Research and Training Institute, Inc./Community Health Institute (JSI/CHI) is creating a MTS Training and Technical Assistance Center. Follow the link to request assistance with technical issues. 

Technical Assistance Guide Available!

Need help?  See the Technical Assistance Guide for answers to operational issues governing Medicaid to Schools reimbursement.

To receive Medicaid payment for healthcare and health related services, schools, providers in schools, or school-based health centers must meet federal and state requirements for Medicaid providers (42 CFR 455.400-455.470).

NH Medicaid may cover services included in a Medicaid eligible student’s individualized education plan (IEP), Section 504 plan, or other written care plan when:

  1. The services are listed in Section 1905(a) of the Social Security Act and are medically necessary;
  2. All federal and state regulations are followed, including those specifying treatment provider qualifications;
  3. The student is Medicaid eligible; and
  4. The services are included in the state plan or available under Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.

Services covered under NH Medicaid via the MTS benefit include, but are not limited to, physical therapy, occupational therapy, speech pathology services, psychological counseling, nursing, and eligible transportation services.

Helpful tips for NH Medicaid provider enrollment:

  • All NH Medicaid provider type 050 enrolled schools should have a “School Information Update” packet from NH Medicaid with their Provider ID and a letter explaining each document included.
  • In order to update your Provider File with NH Medicaid, fill out the appropriate forms located in the School Information Update packet. Fax the “School Information Update” letter along with the forms to NH Provider Relations at 1-866-446-3318 or email from a secure encrypted email to NHProviderRelations@conduent.com.
  • Questions or concerns with the forms should be directed to the NH Medicaid Provider Call Center at 603-223-4774 or 1-866-291-1674.
  • If you would like to schedule additional training, advise the NH Medicaid Provider Call Center and a Provider Field Representative will contact you.

Helpful Provider Resources

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Communications

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Medicaid to Schools Legislation

SB 684 accomplishes three important goals:

  1. SB 684 facilitates the provision of medical services in the school setting to students that are enrolled in participating public schools and in Medicaid by adding public schools to the list of settings where a licensed nurse may delegate the task of administering medicine.
  2. The legislation provides an efficient pathway for the Office of Professional Licensure (OPLC) to license qualified professionals that are certified by the Department of Education (DOE) and are providing health related services to New Hampshire students. Once licensed, schools may be able to seek federal funding for services provided by these licensed professionals. Read more on MTS licensing.
  3. SB 684 adds clarity to the two Medicaid to Schools statutes by addressing medical necessity and aligning the language between the two statutes.

As to licensing, there are provisions related to school psychologists, school social workers, and speech language specialists that are currently certified by and in good standing with the DOE, and were certified on the effective date of the legislation.

Stakeholder Engagement Meetings

The primary goal of MTS Stakeholder Engagement meetings is to elicit feedback and to ensure an open line of communication for questions, concerns, and potential opportunities related to MTS. Information gathered through this process informs future guidance, technical assistance, and trainings related to compliance under the NH Medicaid program.