Arkansas School Medicaid Snapshot
Expansion of School Medicaid Program
Arkansas expanded its school Medicaid program to include behavioral health services delivered to all M4edicaid-enrolled students, in addition to all services included in student IEPs and IFSPs. A state plan amendment was not needed.
- Arkansas Department of Education, Direct Billing: School-Based Mental Health
- Arkansas Department of Human Services, School-Based Mental Health
Coverage & Billing
Arkansas covers the following school-based services:
- Occupational Therapy
- Physical Therapy
- Speech Therapy
- EPSDT Services
- Audiology Services
- Personal Care Services
- Mental Health Services
Eligibility: Medicaid covers certain services only through the Child Health Services (EPSDT) Program for children under age 21.
Billing: The billing providers are the Local Education Agencies (LEAs) and/or Education Services Cooperatives (ESCs). Individual rendering providers are not required to enroll in Medicaid; the school districts and/or ESCs are required to ensure that providers (employees or contractors) meet requirements to provide services. Arkansas does not have Medicaid managed care.
Reference Documents: Arkansas Medicaid in the Schools (MITS) Division of Elementary & Secondary Education
Nursing services are covered as:
- EPSDT screenings and evaluations
- Health education
Providers eligible for reimbursement:
- May vary depending upon whether the school district or cooperative participates as a comprehensive screening provider that will provide all EPSDT screening components, or as a provider for vision and/or hearing screens only.
- If comprehensive, licensed RNs if they have successfully completed a course in child physical assessment provided by the Division of Child and Adolescent Health of the Arkansas Department of Health or the UAMS College of Nursing.
Reference Documents: Child Health Services (EPSDT) Manual, see Certification of Schools to Provide Comprehensive EPST Services
Behavioral Health Services
Behavioral health care is covered as school-based mental health services including: assessment and diagnostic evaluations and interpretations, crisis Intervention, individual therapy, group therapy, and family therapy. In certain circumstances, treatment planning and coordination and referrals to appropriate mental health/community services will be covered.
Providers eligible for reimbursement:
- Licensed Clinical Social Worker with two years experience treating children and adolescents
- Licensed Master Social Worker under supervision of Licensed Clinical Social Worker
- Licensed Professional Counselor with a master’s degree (and 3 years of supervised full-time experience and 2 years of post-licensure experience with children and adolescents)
- Licensed Associate Counselor (LAC) under direct supervision of LPC that is outlined in a plan approved by Board of Examiners in Counseling and provided to the school district or ESC, and 2 years post-licensure experience with children and adolescents
- Licensed School Psychology Specialist (LSPS) with a graduate degree from a North Central Accreditation for Teacher Education accredited institution of higher learning, or one authorized by the Arkansas Department of Education, and who has had a one-year (at least 1,200 hours, and at least 600 of those in a school setting) supervised internship
- Licensed Psychological Examiner (LPE) with two years of academic training, including master’s degree from an applicable accredited educational institution or such training and experience considered equivalent by the Board of Examiners in Psychology, and under supervision of licensed psychologist
- Licensed Psychologist with two years of relevant experience and at least one of those years was postdoctoral work
The student must have a referral from a doctor for services and it must be renewed every six months. Services must be included in a treatment plan.
Reference Document: Arkansas School-Based Mental Health Services Manual; Arkansas State Medicaid Plan
Research Methods & Limitations
The information provided in this analysis represents findings from a 50-state review of publicly available information, most of which was available online as of March 15, 2021. In general, state Medicaid programs require healthcare practitioners to be licensed or authorized in the state in which they are practicing, and services are typically limited to those within the practitioner’s scope of practice under state law. The review for this project did not account for changes that may have been made to Medicaid coverage in response to COVID-19. It also did not include information related to state Medicaid coverage for Applied Behavioral Analysis Therapy in school settings.
Contact your state’s Medicaid agency to verify specific program requirements related to reimbursement. State Medicaid requirements may change at any time, and the information in this document should not be considered as legal or compliance advice.
Prepared by Healthy Schools Campaign. For additional information, visit the School Medicaid Map.