Medicaid Profile

A Medicaid Profile in the context of Special Education (SPED) refers to the student’s eligibility and participation in Medicaid-funded services provided through the school system. Many students with disabilities qualify for Medicaid, and schools can use Medicaid funding to cover the costs of certain services provided under the student’s Individualized Education Program (IEP) or Section 504 Plan.

A Medicaid Profile helps schools track and manage Medicaid-eligible services for special education students. The Written Consent to Bill Medicaid ensures that schools comply with federal laws while allowing them to seek reimbursement for services provided under an IEP or 504 Plan. Parents are encouraged to provide consent, as it does not affect their personal Medicaid benefits if applicable.

While capturing a student’s Medicaid profile, the following fields are collected.

Field Name	Description	Data Flow	Source
Child ID	Unique identifier assigned to the student in the system.	In	Taken from the student’s special education Profile.
First Name	The student's first name as per the record in PowerSchool Special Programs or SIS Profile.	In	Taken from the student’s special education Profile.
Middle Name	The student's middle name is per the record in PowerSchool Special Programs or SIS Profile.	In	Taken from the student’s special education Profile.
Last Name	The student's last name as per the record in PowerSchool Special Programs or SIS Profile.	In	Taken from the student’s special education Profile.
Medicaid Consent Status	Indicates whether the parent/guardian has given written consent to allow Medicaid billing for special education services.	Out	Choose between the following: Agree Disagree Did Not Respond
Medicaid Billing Consent Date	The date when the parent/guardian consented for the school to bill Medicaid for eligible services. This is necessary to reimburse covered services under IDEA (Individuals with Disabilities Education Act).	Out	Use the date picker to enter the date.
Medicaid ID Number	Typically, it would contain the Medicaid identification number assigned to the student for billing and eligibility verification.	Out	Enter the policy number.
Medicaid Eligibility Date	Indicates the date when the student became eligible for Medicaid services. Eligibility must be confirmed before Medicaid can be billed for services.	Out	Use the date picker to enter the date.
Medicaid Comments	In this field, school health staff or Medicaid coordinators record essential details related to the student’s medical or Medicaid-related needs, special circumstances, or adjustments in service provision. Comments might include: Whether a student’s Medicaid eligibility needs to be reverified or updated. Details about services that are authorized or not authorized under Medicaid for SpED services. Updates on any changes in the student’s health or education plan that could affect Medicaid eligibility or coverage. Notes on specific therapeutic or health services that the student is receiving, and whether they are Medicaid-covered.	Out	Enter comments in free-form text. This text can be edited and formatted using the Text Editor feature.