Ways to increase Medicaid reimbursement.

Please see “Part 1” , “Part 2”and “Part 3”before proceeding with Part 4.

With the changes to RMTS beginning with the 2025/26 school year, MSP Final Settlements paid in 2028 will likely decrease for contracted therapy services. To help offset any decrease in Medicaid reimbursement for contracted services and help to increase reimbursement for employed therapy services, here are ways to ensure that your district is maximizing your total MSP reimbursement:

• Make sure that your district is billing for all MSP-covered IEP therapy services, which are: Speech and Language, Occupational Therapy, Physical Therapy, Nursing Services, Audiology Services, Psychology Services, Counseling Services, and Social Work Services.
• Begin tracking and billing for Specialized Transportation Services. This would be for students who cannot be transported on regular buses due to their medical disability.
• Obtain MSP Parental Consent for all students who are receiving therapy services. We cannot bill Medicaid without parental consent.
• Apply for an “Indirect Cost Rate” (ICR) that can be used to increase your costs on your MSP Cost Report. HBS can prepare the ICR return for your district as part of our cost reporting services. The ICR is only applied to employee costs on the MSP cost report.
• Track what your district spends on Medical Supplies and Equipment, to report on the MSP Cost Report. Medical Supplies and Equipment can be reimbursed at 50%.
• Consider going to a “flat rate” billing fee model, which can also be 50% Medicaid reimbursable.
• Provide Medicaid Eligibility Information to parents to encourage Medicaid enrollment. This could increase your “Medicaid Eligibility Rate” (MER) and provide health insurance coverage for eligible families.
• Make sure that therapists are thoroughly trained on RMTS and are answering their selected moments timely and accurately. RMTS is one of the most important factors in computing overall MSP reimbursement.
• Begin identifying administrative staff who coordinate medical services for inclusion in “Medicaid Administrative Claiming” (MAC), which will be added to MSP in the near future, hopefully the 2026/27 school year.
• Begin completing a “School Services Plan of Care” for Non-IEP students who are receiving medical services through a 504 Plan, Nursing Care Plan, Mental Health Plan, or an Absence or Behavioral Intervention Plan. This is what is being referred to as “MSP Expansion” and will be effective beginning 01/01/2026.

Your district should have received information from the Ohio Department of Medicaid (ODM) this week regarding the School Health Services Plan of Care. Our first MSP Bulletin of 2026 will focus on MSP Expansion and how districts can begin getting Medicaid reimbursement for Non-IEP medical services. 2026 will be an exciting year for the Ohio Medicaid School Program as we finally begin implementation of MSP Expansion.

From our entire team at HBS, we would like to wish you and your staff a safe and happy holiday season. We look forward to working with you in 2026 to continue to maximize your MSP reimbursement.

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.