|
42.1 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 allow local school districts, including public charter schools, to obtain Medicaid reimbursement for certain health-related services documented in a student's Individualized Education Program (IEP). SHARS are provided to students who meet all of the following requirements:
• Are under 21 years of age and Medicaid-eligible.
•Meet eligibility requirements for special education described in the Individuals with Disabilities Education Act (IDEA).
•Have IEPs that prescribe the needed services.
Covered SHARS include:
•Audiology services.
•Counseling.
•Nursing services.
•Physician services.
•Occupational therapy (OT).
•Physical therapy (PT).
•Psychological services, including assessments (1-96101).
•Speech therapy services.
•Personal care services.
•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 the Texas Medicaid Program for these services.
The Centers for Medicare & Medicaid Services (CMS) requires SHARS providers to participate in the Random Moment Time Study (RMTS) to be eligible to bill for SHARS direct services. SHARS providers can call the RMTS contracted vendor at 1-888-321-1225.
|
