How Are Local Education Agencies (LEAs) Paid Under Cost-Based Reimbursement? Financing School Based Services Through Medicaid

Many state Medicaid offices use a cost-based system to reimburse service costs and administrative costs associated with school-based service provision. Under cost-based reimbursement, LEAs and state Medicaid offices take routine actions when a Medicaid-eligible school-based service is provided throughout a quarter (or year). At the end of a quarter (or year), additional actions are required to determine settlement payments. This two-page infographic illustrates the LEA's and state Medicaid office's actions under a cost-based reimbursement system.