In May 2023, the Centers for Medicare and Medicaid Services (CMS) released new guidance on school Medicaid that is a clear victory for school health and student health. It affirms that states have flexibility in their school-based Medicaid program to allow school districts to bill Medicaid for health services delivered to all Medicaid-enrolled children, not just students with a special education plan such as an Individualized Education Plan (IEP) or Individualized Family Service Plan (IFSP). The Guide offers pathways states can take to leverage Medicaid funding -- all of which are designed to improve efficiency and reduce administrative barriers -- so more school districts can access sustainable funds for school-based healthcare, including mental health services. This brief answers key questions about the new guidance and highlights what policymakers and advocates need to know -- and how to get involved -- to ensure states are best positioned to leverage federal opportunities so more children have access to the services they need.