What does expanded access in schools mean?
Schools are an ideal environment for delivering health services because they have daily direct contact with children. School-based services improve access to care and reduce the burden on families, particularly by minimizing the need to take time off from work or school and alleviating transportation issues for appointments.
Medicaid also provides reimbursement to school districts for the administrative tasks related to and in support of delivering health services. This includes reimbursement for outreach efforts, facilitating Medicaid eligibility determinations, Medicaid-related training, and general administration.
School districts can bill for services included in children's Individualized Education Plans (IEPs) or for medically necessary services through Expanded Access. This Expanded Access was implemented in 2019 when the Kentucky Department for Medicaid Services submitted a State Plan Amendment to extend school-based Medicaid services to all children enrolled in Medicaid, regardless of whether the child has an IEP.
Grant Funds Available to LEAs Enhancing Behavioral Health Services
The Cabinet for Health and Family Services (CHFS), Kentucky Department for Medicaid Services (DMS) is making available grant funding to allow local education agencies (LEAs) to address critical gaps and enhance existing behavioral health services in its school-based Medicaid program. LEAs throughout the Commonwealth are eligible to apply for funds to build workforce capacity, technology infrastructure, outreach campaigns, and more to better meet the behavioral health needs of students.
The Notice of Funding Opportunity (NOFO) can be accessed through this document. The deadline to apply is March 13, 2026. An informational webinar will be held on February 23, 2026, to provide additional information and answer questions. Register for the webinar. We encourage you to take advantage of this opportunity.
Expanded Access Billing Instructions
To receive Medicaid reimbursement for health services under Expanded Access, the following criteria must be met:
1. The service must be medically necessary.
2. It must be a covered service provided by a credentialed practitioner to a child enrolled in Medicaid.
3. The service must be offered to all students at no cost.
Often, the Expanded Access services are those that Local Education Agencies (school districts) have been providing for years without reimbursement.
Common services provided in school settings include behavioral and physical health services, flu and strep tests, as well as occupational, physical, and speech therapies.
The Department for Medicaid Services offers guidance to school districts on delivering these health services through the Technical Assistance Guide. This guide is updated at least once a year and includes information on definitions, documentation requirements, covered services, qualified providers, and billing instructions.
School-Based Services Toolkit
School personnel, healthcare providers, administrators, parents, and students can help spread the word and learn more about Medicaid school-based health services by using this toolkit. The materials include informational flyers, articles, social media posts, and other resources to promote the program.
Informational Materials
Download these materials and customize them for your school! These materials can be shared with other school personnel, administrators, school board members, and parents! This will help to raise awareness of the availability of Medicaid school-based health services and help more students access the care they need, including behavioral health care!
Social Media Materials
These graphics can be downloaded and shared on various social media platforms. The links provide general promotional graphics and social media "frames" designed to help promote school-based health personnel, such as nurses, behavioral health practitioners, and doctors. To use them, simply add the frame to a design application like Canva, take a photo of a healthcare provider, and upload it to the frame!