Types of Medical Services

School-Based Services

Pursuant to federal law, school districts may provide Medicaid-covered services for eligible Medicaid recipients during the school day. South Dakota Medical Assistance reimburses school districts for the costs of providing psychological services, physical therapy, occupational therapy, speech therapy, audiological services, and nursing services.

Specific information and instructions are available in the Professional Services Manual.

Below are important considerations which apply to school-based services:

• The school district must be an enrolled Medicaid provider with an active provider number;
• Services must be medically necessary and covered/prescribed in a plan of care (e.g., an IEP);
• Routine nursing services, such as treatment of minor abrasions, cuts, and contusions, recording of temperature or blood pressure, and evaluation or assessment of acute illness, which are provided to all students are not covered;
• Certain restrictions and limits apply to the respective services;
• Personnel providing the services must meet professional licensure and certification requirements specific to the particular service; and
• The school district must obtain a signed, parental consent form authorizing use of medical assistance from the parent or legal guardian of the child for whom services are being provided.