School-Based Health Center (SBHC) Carve-In – Delayed to 4/1/26
The School-Based Health Center (SBHC) Medicaid managed care carve-in, originally scheduled to take effect on April 1, 2025, has been delayed to April 1, 2026.
When the carve-in takes effect, SBHC services will be billed to Medicaid Managed Care Organizations (MCOs) rather than through Medicaid Fee-for-Service (FFS). This shift will impact billing procedures, contracting requirements, and revenue cycle processes for health centers operating SBHCs.
To support health centers in preparing for this change, CHCANYS hosted a webinar presented by CohnReznick. The session outlines the steps health centers should take to assess readiness, identify billing and operational adjustments, and begin engaging with managed care plans.
Access the Presentation Slides Here: Transition of SBHC Benefit into Medicaid Managed Care
We encourage all health centers with SBHCs to review the materials and begin planning for the April 1, 2026 transition.