Seeking reimbursement for health-related services as part of a student's individualized education program (IEP) or Individualized Family Service Plan (IFSP).
Third party Medicaid billing helps to access funds to support Minnesota schools in building capacity to provide better health and behavioral health services to students.
Federal and state law require all public Minnesota schools to request payment for IEP health-related services from public and private health insurers. Minnesota Health Care Programs (MHCP) pays the federal share of covered health-related services described on a child’s IEP or IFSP.
- Physical therapy.
- Occupational therapy.
- Speech-language-hearing.
- Children’s Therapeutic Services and Supports (Mental Health).
- Nursing.
- Personal care assistance services.
- Assistive technology devices (medical equipment).
- Interpreter services when needed during a medical service.
Brochures for Parents
- English: Individualized Education Program (IEP) Services (DHS-3456) (PDF)
- Lus Hmoob – Hmong (PDF)
- Pусский – Russian (PDF)
- Af Soomaali – Somali (PDF)
- Español – Spanish (PDF)
- Tiếng Việt – Vietnamese (PDF)
For more information on upcoming trainings, recordings, insurance denials and other billing related materials, request an invitation from Julie Neururer to access the third party reimbursement (TPR) SharePoint site.
Current Centers for Medicare and Medicaid Services (CMS) Guidance
- Center for Medicaid and CHIP Services (CMCS) Informational Bulletin: Information on School-Based Services in Medicaid: Policy Flexibilities and Guide on Coverage, Billing, Reimbursement, Documentation and School-Based Administrative Claiming
- Comprehensive Guide to Medicaid Services and Administrative Claiming (CMS)
- Fact Sheet: Delivering Service in School-based Settings: A Comprehensive Guide to Medicaid Services and Administrative Claiming
- Press Release: Proposed Rule to Help Schools Deliver Critical Health Care Services to Millions of Students
Proposed Rule Change from Office of Special Education and Rehabilitative Services, Department of Education (ED)
- Proposed rule on parental consent (ED): comment period ends August 1, 2023
- - 10/24/23 PDF
Agreement regarding third party reimbursement between Department of Human Services and Department of Education
- Third Party Reimbursement and School-based Community Services in the Schools - 9/7/22
Federal Medicaid reimbursements support Minnesota schools in building capacity to provide health services—including mental health services.
- Medicaid for School Mental Health Services - 9/7/22
School districts must access Medicaid reimbursement for school-based mental health services through the state’s Children’s Therapeutic Services and Supports (CTSS) program.
- Consent form for Health-Related Services - Third Party Billing - 5/6/22
Consent form for Part C and Part B third party billing -- federally approved
- Medical Assistance Billing Information and Consent Policy Revision - 4/6/21
Questions and answers about revisions to medical assistance billing and consent policies effective July 1, 2013.
- - 10/30/18
Minnesota Departments of Education and Human Services contacts for questions and issues related to third-party reimbursement.
- Special Education Third Party Reimbursement - ICD-10-CM Coding Progress memo - 8/16/16
January 22, 2016 memo about progress with and resources for coding for third party reimbursement.
- Parent Consent to Share Data and Seek Payment for Individualized Education Program (IEP) Health Related Services - 11/9/15
Parental consent form for Part B only
- Part C Annual Notice for Third Party Billing - 10/6/15
System of Payments Policy for Part C Third Party Billing -- federally approved.
- Third Party Reimbursement: Private Insurance Coverage - 5/1/15
MDE obtains responses from private health insurance plans on behalf of school districts statewide to reduce duplication of effort and expedite billing. Find the steps school districts must take.
Translated Documents
- Written Annual Notice Related to Third Party Billing for IFSP Health-Related Services (Hmong) - 6/7/24
Written Annual Notice Related to Third Party Billing for IFSP Health-Related Services (Hmong)
- Written Annual Notice Related to Third Party Billing for IFSP Health-Related Services (Spanish) - 6/4/24
Written Annual Notice Related to Third Party Billing for IFSP Health-Related Services (Spanish)
- Written Annual Notice Related to Third Party Billing for IFSP Health-Related Services (Somali) - 6/4/24
Written Annual Notice Related to Third Party Billing for IFSP Health-Related Services (Somali)
- Consent form for Health-Related Services - Third Party Billing (Hmong) - 1/18/23
Consent form for Part C and Part B third party billing -- federally approved (Hmong translation)
- Consent form for Health-Related Services - Third Party Billing (Somali) - 1/18/23
Consent form for Part C and Part B third party billing -- federally approved (Somali translation)
- Consent form for Health-Related Services - Third Party Billing (Spanish) - 1/18/23
Consent form for Part C and Part B third party billing -- federally approved (Spanish translation)
- Consent form for Third Party Billing Health-Related Services - Spanish - 4/9/20
Consent form for Part C and Part B third party billing
- Consent form for Third Party Billing Health-Related Services - Vietnamese - 10/28/15
Consent form for Part C and Part B third party billing
- Consent form for Third Party Billing Health-Related Services - Russian - 10/28/15
Consent form for Part C and Part B third party billing
- Consent form for Third Party Billing Health-Related Services - Hmong - 10/28/15
Consent form for Part C and Part B third party billing
- Consent form for Third Party Billing Health-Related Services - Somali - 10/28/15
Consent form for Part C and Part B third party billing
Medicaid billing though Third Party Reimbursement and School-Based Community Services helps access funds to support Minnesota schools in building capacity to provide better health and behavioral health services to students
Related MDE resources:
Related offsite resources:
- Technical Assistance Center - Medicaid.gov
- Individualized Education Program (IEP) Services Provider Manual - Department of Human Services
- Minnesota Health Care Provider Manual - Individualized Education Programs - Department of Human Services
- School-Based Community Services (SBCS)
Contact MDE: 651-582-8200 No English? Call: 651-785-4064 Visit: አማርኛ Lus Hmoob ကညီ Afaan Oromo Af Soomaali Español українська
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Minnesota Department of Education
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or if you have a disability and need assistance,
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