Ohio Medicaid School Program Bulletin — HBS 2026-1
Effective January 1, 2026, the Ohio Medicaid School Program has expanded to allow for Medicaid reimbursement for direct medical services and assessments provided to students on the following Non-IEP Care Plans:
- 504 Plans
- Nursing Care Plans
- Behavioral Intervention Plans
- Absence Intervention Plans
- Mental Health Treatment Plans
- Safety Plans
- Individualized Health Plans (IHP)
- Child and Family Centered Plans (CANS)
- Occupational Therapy Plans
- Physical Therapy Plans
- Seizure Action Plans
- Asthma Management Plans
- Diabetes Management Plans
- School Services Plan of Care
To meet the “medical necessity” requirements for Medicaid reimbursement, the above Plan of Care must be attached and incorporated into the Ohio Department of Medicaid (ODM) “School Services Plan of Care”. If the Non-IEP Care Plan contains all the Medicaid required components, the only sections that need completed on the School Services Plan of Care are:
- Page 1 — Student Demographic Information
- Page 2 — Required Signatures
- Page 3 — Alternative Documentation Checklist
The Medicaid required components that need to be included in the Non-IEP Plan of Care are:
- Description of need based on an assessment conducted by an authorized school district provider or community provider.
- Signed by the authorized school district provider.
- Include specific services used, and amount, duration, and frequency of each service.
- Include specific goals to be achieved.
- Specify timelines for re-assessment that is no more than twelve months from date of initial assessment.
- Include specific criteria regarding referrals to community providers, when appropriate.
- For Nursing Services, reference and identify the location of the prescription of the physician.
See pages 4, 5, and 6 of the School Services Plan of Care for required component examples. If you incorporate these components into your existing Non-IEP Plans of care, only pages 1, 2, and 3 need to be completed on the School Services Plan of Care.
HBS will be adding the School Services Plan of Care (link below) to our online MSP service documentation software that your therapists currently use to document their MSP services. The form can be completed, saved, and maintained in our system. The Non-IEP Plan of Care can be imported and saved in our system as well. We are also adding a School Services Plan of Care training video in our billing software along with our other MSP training videos.
If you have any questions or need further information on any of our Ohio MSP Bulletins, please contact our office at (740) 639-4218 or email at Info@teamhbs.com.