Third Party Reimbursement

What is Third Party Reimbursement?

Seeking reimbursement for health-related services as part of a student's individualized education program (IEP) or Individualized Family Service Plan (IFSP).

Third party reimbursement allows schools to seek reimbursement for IEP health-related services from public and private health insurers.

Federal and state law require all public Minnesota schools to request payment for 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 IFSP.

Schools are reimbursed when a child has a disability and an IEP or IFSP, requires health-related services to benefit from special education, and is eligible for MHCP (which includes Medical Assistance (MA), MinnesotaCare and other public, government health programs). Reimbursable IEP or IFSP 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).
Parents / guardians of children with disabilities must be fully informed before consenting to schools sharing information with the Minnesota Department of Human Services (DHS) and to bill. See the consent policy and form below.

See the related links on this page for legal requirements, school finance instructions and guidance from DHS, the Medicaid authority in Minnesota.

The third party reimbursement (TPR) SharePoint site provides access to the latest materials for coordinators and staff setting up the TPR system and billing. For access to the TPR SharePoint site, contact Julie Neururer.

  • Medical Assistance Billing Information and Consent Policy Revision - 4/6/21
    Questions and answers about revisions to medical assistance billing and consent policies effective July 1, 2013.
  •  - 10/30/18
    Minnesota Departments of Education and Human Services contacts for questions and issues related to third-party reimbursement.
  •  - 9/14/18  pdf iconPDF 
    Agreement regarding third party reimbursement between Department of Human Services and Department of Education
  • Consent form for Third Party Billing Health-Related Services - 5/31/17  pdf iconPDF 
    Consent form for Part C and Part B third party billing -- federally approved. Includes Microsoft Word version for local use.
  • Special Education Third Party Reimbursement - ICD-10-CM Coding Progress memo - 8/16/16
    January 22, 2016 memo about progress with and resources for coding for third party reimbursement.
  • Parent Consent to Share Data and Seek Payment for Individualized Education Program (IEP) Health Related Services - 11/9/15
    Parental consent form for Part B only
  • Part C Annual Notice for Third Party Billing - 10/6/15
    System of Payments Policy for Part C Third Party Billing -- federally approved.
  • Third Party Reimbursement: Private Insurance Coverage - 5/1/15
    MDE obtains responses from private health insurance plans on behalf of school districts statewide to reduce duplication of effort and expedite billing. Find the steps school districts must take.

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