Opportunity Overview
The Vermont Medicaid School-Based Services (SBS) Expansion is a statewide Medicaid reimbursement pathway administered by the Vermont Agency of Human Services and Department of Vermont Health Access in collaboration with the Agency of Education. Beginning October 1, 2026, Vermont will unify Medicaid Administrative Claiming and School-Based Health Services and expand reimbursement beyond IEP-only services to medically necessary services delivered at school to Medicaid-enrolled students.
Funding Structure
This is not a competitive grant with a fixed award ceiling. Vermont is moving participating LEAs to a cost-based reimbursement model using the Random Moment Time Study (RMTS) and quarterly cost reporting. DVHA states that reimbursement can increase as LEA costs increase. No per-LEA maximum or statewide competitive funding pool is published.
Covered Services
Pending final federal approval where indicated by the State, the expanded service categories include assessment and evaluation, audiology, applied behavior analysis, durable medical equipment, medical evaluation, examination and consultation, mental health, nursing, nutrition, occupational therapy, orientation and mobility, personal care, physical therapy, specialized transportation, speech-language services and vision care.
LEA Participation Requirements
Beginning October 1, 2026, all Supervisory Unions and Supervisory Districts must participate in the RMTS for cost-based reimbursement. LEAs must maintain accurate rosters of school-based providers, including staff and contracted providers whose time is billed to Medicaid, and submit quarterly cost reports. DVHA has now released the SBS Program Manual, role-based covered-service supplements, and interim encounter-reporting guidance effective October 1, 2026. Vermont is also implementing the statewide VT NEST electronic health record and Medicaid billing solution; the State will provide the EHR to schools at no cost. DVHA currently plans a single-school-district VT NEST pilot in January 2027 followed by phased cohort rollouts. Interim encounter reporting begins October 1 and continues until each LEA adopts VT NEST.
Eligibility
Vermont LEAs and participating school-based providers are the operative entities in this reimbursement pathway. Reimbursement remains subject to Medicaid enrollment, medical necessity, provider qualifications, documentation, covered-service rules, RMTS participation, cost reporting and other State and federal Medicaid requirements.
N9+ and QC Healthcare Analysis
Atlas Opportunity Score: 94/100. This is a major statewide school-health funding pathway with recurring reimbursement potential, broad service categories and strong relevance to rural and underserved school-based care.
N9+ Fit: 70/100, conditional. The Nonagon N9+ remote physical examination platform has a legitimate clinical-use connection to the program because Vermont expressly includes medical evaluation, examination and consultation among the expanded service categories. Guided examinations, vitals and telehealth-enabled clinical encounters could support school-based access in an appropriate clinical model. However, Vermont has not established that the N9+ device/platform itself is separately reimbursable equipment or an automatically allowable cost. Any N9+ deployment must be tied to covered, medically necessary services and confirmed under the final SBS rules.
QC Healthcare Fit: 75/100, conditional. QC Healthcare may have a legitimate contracted-provider or clinical-services role where an LEA needs qualified medical support and all Vermont licensure, Medicaid enrollment, contracting, documentation and billing requirements are satisfied. Contracted providers can appear on LEA RMTS rosters when their time is billed to Medicaid.
Direct Vendor Review
Dr. Miltie is not the Medicaid applicant or reimbursement recipient. The credible route is an LEA-led school-health model with Dr. Miltie/QC Healthcare participating only where the LEA’s clinical program, procurement process and Medicaid requirements support that role. Atlas should not characterize the N9+ device itself as reimbursable without explicit confirmation.
Next Action
Vermont LEAs should complete SBS readiness work for October 1, confirm RMTS rosters and interim encounter reporting, prepare for VT NEST adoption, and map current and planned school-health services to the final covered-service supplements. Any Atlas/N9+/QC Healthcare project should be validated against provider enrollment, medical necessity, service documentation, procurement and reimbursement rules before implementation.
Program contact: AHS.SBSMedicaid@vermont.gov.
Official sources: Vermont Agency of Education, Education Medicaid: School-Based Health Services and Department of Vermont Health Access, Medicaid School-Based Services.