WCH: School Nursing: Medicaid Reimbursement for School Nursing Services

Nurse talking with seated student

Local Education Agencies (LEAs) may bill Medicaid for cost reimbursement when providing qualifying nursing services to students in schools who are Medicaid beneficiaries. Policy language includes medically necessary evaluations and treatments provided to a NC Medicaid-eligible beneficiary when the service is documented on an Individual Education Program (IEP), Individual Family Service Plan, Individual Healthcare Plan (IHP), Behavior Intervention plan, or 504 plan. Nursing services are covered when they are directly related to a written nursing plan of care (POC), based on an order from a licensed provider and included on a student’s IHP. Related resources are available below.

Last Modified: 1-21-2021