Third Party Reimbursement for IEP Health Related Services

Federal and state law require all public Minnesota schools to request payment for Individualized Education Program (IEP) health-related services from public and private health insurers. Minnesota Health Care Programs (MHCP) pays the federal share of covered health-related services described on a child’s IEP or Individualized Family Service Plan (IFSP).

Schools are reimbursed when a child has as a disability and an IEP or IFSP, requires health-related services in order to benefit from special education and is eligible for Minnesota Health Care Programs (MHCP) (which includes Medical Assistance (MA), MinnesotaCare and other public, government health programs). Reimbursable IEP health related services include assessments and services for:

  • Physical therapy.
  • Occupational therapy.
  • Speech-language-hearing.
  • Children’s Therapeutic Services and Systems (Mental Health).
  • Nursing.
  • Personal care assistance services.
  • Assistive technology devices (medical equipment).
  • Special transportation (Department of Human Services (DHS) definition).
  • Oral and sign language interpreter services during above service.

Services eligible for payment must meet all of the following criteria:

  • Medically necessary
  • Provided to an eligible MA or MinnesotaCare enrollee under the age of 21
  • Included in the child/student's IEP, IFSP, IIIP
  • Health related services necessary for the child/student to benefit from his/her education
  • Provided by qualified service providers within the service provider's scope of practice and/or licensure/certification
  • Authorized by the child/student's IEP/IFSP/IIIP team; and
  • Provided by the school during the school day

IEP Health Related Services eligible for Medical Assistance payment must meet the  criteria in the Minnesota Department of Human Services IEP Technical Assistance Guide (DHS, 2011, IEP Technical Assistance Guide, Retrieved on July 13, 2011). More information is available on the Minnesota Department of Human Services Website or in the brochures posted below.

For additional questions about third party reimbursement, please contact Special Services at (651) 306-7821

DHS Information for Families- English
DHS Information for Families- Spanish