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3. School Health and Related Services (SHARS)
3.1 Overview
Medicaid services provided by school districts in Texas to Medicaid-eligible students are known as SHARS. The oversight of SHARS is a cooperative effort between the Texas Education Agency (TEA) and HHSC. SHARS allows local school districts, including public charter schools, to obtain Medicaid reimbursement for certain health-related services that are documented in a student's Individualized Education Program (IEP). SHARS are provided to students who meet all of the following requirements:
• Are 20 years of age and younger and eligible for Medicaid
•Meet eligibility requirements for special education described in the Individuals with Disabilities Education Act (IDEA)
•Have IEPs that prescribe the needed services
Services covered by SHARS includes:
•Audiology services
•Counseling
•Nursing services
•Occupational therapy (OT)
•Personal care services (PCS)
•Physical therapy (PT)
•Physician services
•Psychological services, including assessments (procedure code 96101)
•Speech therapy (ST)
•Transportation in a school setting
These services must be provided by qualified personnel who are under contract with or employed by the school district. Furthermore, the school district must be enrolled as a SHARS Medicaid provider in order to bill Texas Medicaid for these services.
Important: The Centers for Medicare & Medicaid Services (CMS) requires SHARS providers to participate in the Random Moment Time Study (RMTS), to be eligible to bill and receive reimbursement for SHARS direct services, and submit an annual SHARS Cost Report.
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