MedicaidCoverageMedium impact
School-Based Health Services Program Expansion Approval
Illinois Medicaid - HFS·IL · Pediatrics, Psychiatry, Occupational Therapy +2 more·Provider Notice
Effective date
Jul 1, 2021
We identified it
Jun 20, 2026
Summary
Illinois has expanded its School-Based Health Services Medicaid program to cover all Medicaid-enrolled students (not just special education students) and switched to a cost settlement reimbursement methodology. School-based practitioners can now bill Medicaid for medically necessary services provided to any enrolled student with proper documentation.
Action Required
By May 12, 2023: Illinois school-based health providers must complete the First Day of School Survey by noon to avoid program suspension. School-based practitioners should expand billing to include all Medicaid-enrolled students (not just IEP/IFSP students) with documented medical necessity in health plans, 504 plans, or doctor's orders. Update documentation to include service scope, frequency, duration, and clinical rationale. Sign new Intergovernmental Agreements when circulated by PCG in coming weeks.