Third Party Reimbursement for Health-Related Services

  • Since July 1, 2000, Minnesota school districts are required to bill for Individualized Education Program (IEP) health related services that are listed on an IEP.

    Covered IEP health related services through Medical Assistance include speech-language pathology and audiology services, occupational therapy, physical therapy, nursing services, mental health services (social work services, and school psychologist services), Children’s Therapeutic Services and Supports (CTSS), personal care assistant (PCA)/paraprofessional services, interpreter services (including spoken language, and sign language), assistive technology devices and special transportation.

    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 or IFSP
    • 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
    • Documented electronically on a service log in EdPlan
    • 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 from the Minnesota Department of Human Services (DHS) IEP Technical Assistance Guide

    For assistance please contact the Third Party Reimbursement Office.

    • Janet Lowe: 651-767-8189 or janet.lowe@spps.org
    • Dina Funk: 651-767-8191 or dina.funk@spps.org
    • Jennifer Nordstrand: 651-767-8382 or jennifer.nordstrand@spps.org
    • Kari Thein: 651-295-3593 or kari.thein@spps.org

    Fax: 651-228-3649 (be sure to include the area code)

    Address:

    360 Colborne Street

    4th Floor, room 420

    St. Paul, MN 55102