Maximizing School Medicaid for Substance Use Prevention, Early Intervention & Treatment: 10 Actions States Can Take Now

May 1, 2024

This report offers an in-depth look at how states can shape their school Medicaid program to increase reimbursement for substance use services and supports.

Drawing on recent legislative and regulatory policy changes, and new guidance from the Centers for Medicare and Medicaid Services, it includes 10 specific, practical measures to help school districts get reimbursed for all services — including EPSDT services — covered by the Medicaid state plan.

Recommendations include providing clear guidelines for covering substance use prevention (in addition to screening and treatment) and ensuring that providers who specialize in school-based substance use prevention are included in the list of qualified Medicaid providers.

The additional and sustainable funding states and school districts receive can create opportunities for more equitable access to healthcare.