Medicaid Standards
Using Medicaid Funding for MST
Medicaid funding strengthens the long-term viability of MST programs, helping expand access for youth and families. Still, sole dependence on Medicaid can limit full model adherence. Success requires addressing eligibility gaps, staffing expectations, training, and operational requirements across the program.
Funding for Non-Medicaid Eligible Youth/Clients
MST programs must ensure sustainable funding for youth who do not meet Medicaid eligibility criteria. Blended or braided funding strategies help maintain equitable access and uphold model adherence across all referred families.
Staff Training and Program Quality Assurance Requirements
High-quality MST depends on comprehensive training, ongoing coaching, and continuous quality assurance. Medicaid funding may not cover all required activities, so programs must plan for supplemental support to maintain fidelity and achieve strong outcomes.
Staffing Requirements for Supervisors and Therapists
Model-adherent MST relies on specific staffing ratios, caseload expectations, and dedicated supervisory structures. Medicaid reimbursement alone may not fully support these requirements, making strategic funding alignment essential for clinical and operational success.
Program Operational Requirements
Implementing MST effectively requires infrastructure for 24/7 availability, timely response, data tracking, and collaboration with referral sources. Programs should evaluate how Medicaid funding fits within broader operational needs to ensure consistent service delivery.
Admission, Exclusion and Discharge Criteria
MST’s defined admission and discharge criteria ensure youth are matched to the right level of care and fidelity is preserved. Medicaid rules may introduce added constraints, so programs should align criteria early to prevent gaps in care or reimbursement challenges.
Medicaid Funding Resources
This packet provides core guidance for developing sustainable, Medicaid-supported MST programs. It includes MST’s position on Medicaid funding, the Preferred Service Description and rating form, details on using the H2033 HCPCS code, and a current listing of state service descriptions with MST Services ratings—all designed to help states and providers align funding structures with model fidelity.
Download this packet to explore how states use Medicaid to support MST and achieve meaningful cost benefits. Inside, you’ll find selected Medicaid rate examples and clear steps a state Medicaid system can take to add MST to its approved programs—providing a practical roadmap for expanding access sustainably.
For those interested in assistance with Request For Proposal (RFP) development, please refer to MST RFP Template link below. This file is helpful when writing an RFP for an MST program as it contains the elements that should be included in the RFP for MST.
