We recently surveyed 277 healthcare leaders to learn more about how they measure the impact of interpreting services in their organizations. One finding that stood out to us is that cost is still the #1 barrier to providing these services. While counterintuitive, interpreting services actually lower costs and improve outcomes in outcome-based incentive programs like value-based care.
Studies show that interpreting helps reduce readmission rates, shorten hospital stays, and improve patient satisfaction. That doesn’t just support better outcomes, it supports better reimbursement. Check out our eBook on VBC and interpreting services to learn more about proving the ROI of interpreting and how to track LEP patients as a cohort.
In this article though, we’ll take a closer look at how Medicaid and CHIP (Children’s Health Insurance Program) reimburse language services—and how healthcare providers can better understand and use these models to improve access, outcomes, and sustainability.
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Medicaid and CHIP: How Language Services Get Reimbursed
Language services can be reimbursed in two main ways under Medicaid and CHIP:
As an administrative expense: This means interpretation is considered a cost of doing business and is reimbursed as part of a provider’s administrative overhead.
As a covered service: In this case, interpretation is recognized as part of the care provided to the patient and reimbursed directly, often with set rates.
Both models are rooted in federal mandates that ensure meaningful access to healthcare for people with limited English proficiency (LEP). These include:
- Title VI of the Civil Rights Act
- Section 1557 of the Affordable Care Act
- Section 504 of the Rehabilitation Act
Still, how these laws are implemented and how providers get reimbursed varies widely from state to state.
Two Main State Models
Across the US, two primary models dominate how states manage Medicaid/CHIP language service reimbursement:
Managed Care Model
States like California and Minnesota use Managed Care Organizations (MCOs), which can include language services in their contracts. MCOs focus on controlling costs while maintaining or improving the quality of care for their members. They do this by contracting with networks of hospitals or healthcare providers and applying management techniques like negotiated service rates, promoting preventative care, and requiring prior authorizations. While this model offers flexibility, it can also create variability in how language services are implemented and reimbursed.
Fee-for-Service (Direct Reimbursement) Model
States like Iowa and Rhode Island directly reimburse providers for interpreting services through Medicaid using a Fee-for-Service (FFS) model. In this approach, hospitals and providers are paid for each service they provide to a patient. It tends to be more straightforward, but reimbursement rates and policies can still vary significantly across states.
Highlights from the 2024 Report
The 2024 Medicaid and CHIP Reimbursement Models report offers some eye-opening insights into how language access is handled across the country. Here are a few key takeaways:
Reimbursement Rates Vary
There’s no national standard for rates, and the differences are striking:
- Idaho pays just $3.04 per 15 minutes
- New Hampshire reimburses up to $98.54 per session
These rates affect both access and the financial viability of providing services, especially for smaller health systems and clinics.
Telehealth
The COVID-19 Public Health Emergency turbocharged the adoption of telehealth, including remote language services. States like Minnesota and Oregon now explicitly support video remote interpreting (VRI) and over-the-phone interpreting (OPI) as reimbursable services under Medicaid.
Interpreter Standards Are Inconsistent
Some states, like Oregon and Minnesota, maintain registries and enforce interpreter qualifications. Others leave the decision up to healthcare providers. This inconsistency can lead to confusion and gaps in service quality.
What You Need to Know for CHIP Reimbursements
If you’re navigating Medicaid or CHIP reimbursements for interpreting services, here’s what you need to know:
1. Interpreter Standards Are Inconsistent
Every state has different policies. Understanding your specific Medicaid and CHIP reimbursement models is key to maximizing funding and compliance.
2. Leverage Telehealth Wisely
Telehealth makes interpreting services more accessible, especially in rural areas. Ensure your tech stack and interpreting platforms are aligned with Medicaid’s requirements.
3. Build with Reimbursement in Mind
Whether you’re building a language access program or improving an existing one, make sure your approach matches your state’s billing structures and compliance standards.
Why This Matters
When patients can clearly understand their treatments, everything improves: trust, outcomes, and efficiency. And when providers understand how to get reimbursed, they can scale these services sustainably.
Looking Ahead
As Medicaid and CHIP continue evolving, more states may move toward uniform standards or expanded telehealth reimbursements. Providers that stay ahead of these changes and adapt quickly will be best positioned to deliver equitable, high-quality care.
What You Need to Know for CHIP Reimbursements
Clear, accessible communication is the foundation of good healthcare. Medicaid and CHIP reimbursement models may be complex, but they’re also full of opportunity if you know where to look.
Let’s keep the conversation going. The more providers understand these models, the more we can push for equity, sustainability, and smarter healthcare delivery.
