SBHS Notification

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School-based health care services (SBHS) notification

October 20, 2022

*Attention School District SBHS Medicaid Coordinators--please share this notification with the district staff who process SBHS Medicaid reimbursements*

Breakdown of SBHS Medicaid reimbursements

For dates of service after July 1, 2022, the School-Based Health Care Services (SBHS) Program no longer requires SBHS-contracted school districts to provide local matching funds to the Health Care Authority (HCA). In order to track paid and denied SBHS claims, school districts may review the remittance advices (RAs) which are available in ProviderOne. Directions on how to view the RAs and more information about the SBHS claims payment process can be found in the SBHS billing guide in the Billing and Payment section. The remittance advice does not show the breakdown of Federal and State funds and, therefore, the breakdown has been provided below. 

For dates of service after July 1, 2022, the Federal and State breakdown for SBHS Medicaid reimbursements is:

Federal: 56.2%

State: 43.8%

Federal match is expected to stay at 56.2% during the remainder of the Federal public health emergency (PHE). At the end of the Federal PHE, the breakdown is expected to be 50% Federal/50% State. HCA will notify school districts via GovDelivery when and if the Federal/State breakdown changes. 


Any questions regarding this notification may be directed to HCA's SBHS program manager

About the SBHS Program

The Washington State School-Based Health Care Services (SBHS) Program is administered by the Health Care Authority (HCA). School districts participating in the SBHS Program may receive reimbursement for providing health care-related services to Title XIX Medicaid-eligible students with Individualized Education Programs (IEPs) or Individualized Family Service Plans (IFSPs). Visit the SBHS webpage for more information.

Please feel free to share SBHS news with your colleagues!

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