Rule 5160-35-07 | Services that can be provided by medicaid school program (MSP) providers to eligible children enrolled in medicaid without a plan of care.
(A) The purpose of this rule is to set forth the services authorized for medicaid coverage, beyond those indicated in rules 5160-35-05 and 5160-35-06 of the Administrative Code, that an MSP provider can provide, and to set forth the conditions for providing the services.
(B) MSP providers listed in rule 5160-35-05 of the Administrative Code are authorized to provide services to eligible children without a school services plan of care or an IEP defined in paragraph (B) of rule 5160-35-05 of the Administrative Code with sufficient documentation of medical necessity:
(1) Physical, mental, and behavioral health screenings recognized as valid and within scope of practice by the direct service providers listed in rule 5160-35-05 of the Administrative Code, and used to identify eligible children who may be at risk of experiencing physical, mental, or behavioral health conditions, and refer for services as appropriate.
(2) Administration of medication prescribed in accordance with paragraph (A)(11) of rule 5160-35-01 of the Administrative Code.
(3) Contacting the prescribing or ordering providers about prescription or treatment orders.
(4) Consultation with parents and providers regarding a physical, mental, or behavioral health condition or diagnosis.
(5) Administration of the children and adolescent strengths and needs (CANS) assessment as defined in rule 5160-59-01 of the Administrative Code for children who have not had a CANS assessment previously completed.
(6) Direct service activities to address tobacco prevention, cessation, and vaping.
(7) Screening, brief intervention, referral, and treatment (SBIRT) as defined in rule 5160-27-02 of the Administrative Code.
(C) Services provided to an eligible child as described in this rule are subject to all provisions described in rules 5160-35-02 and 5160-35-04 of the Administrative Code.
(D) Services provided to an eligible child as described in this rule are subject to provisions listed in paragraphs (F), (G), (H), (K), (L), and (M) of rule 5160-35-05 of the Administrative Code.
(E) Documentation of MSP services provided to an eligible child described in this rule is subject to provisions described in paragraph (F) of rule 5160-35-06 of the Administrative Code.
Last updated January 1, 2026 at 12:00 AM
Supplemental Information