NC Medicaid Expands School-Based Services and Reimbursement for Local Education Agencies
Effective July 1, 2026, NC Medicaid has implemented significant clinical policy and reimbursement updates for School-Based Services (SBS) provided by Local Education Agencies. These changes, driven by the Bipartisan Safer Communities Act and guidance from The Centers for Medicare & Medicaid Services (CMS), aim to enhance access to physical and mental health services within school environments. Key clinical updates include expanding the types of eligible behavioral health providers to include school psychologist interns, licensed marriage and family therapists, licensed clinical addiction specialists, physician assistants, nurse practitioners, licensed behavioral analysts, and medical doctors. The policy also broadens service plans beyond Individualized Education Programs (IEPs) to include other written plans within a provider's scope of practice and expands eligible services to encompass behavioral health-related services, nursing assessments, and crisis services. Additionally, CPT codes for telehealth and...