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42.6.10 Transportation Services in a School Setting
Transportation services in a school setting are reimbursed when they are provided on a specially-adapted vehicle and if the following criteria are met:
• Provided to and/or from a Medicaid-covered service on the day for which the claim is made.
•A child requires transportation in a specially-adapted vehicle to serve the needs of the disabled.
•A child resides in an area that does not have school bus transportation, such as those in close proximity to a school.
•The Medicaid-covered SHARS is included in the student's IEP.
•The special transportation service is included in the student's IEP.
A specially-adapted vehicle is one that has been physically modified (e.g., addition of a wheelchair lift, addition of seatbelts or harnesses, addition of child protective seating, or addition of air conditioning). A bus monitor or other personnel accompanying children on the bus is not considered an allowable special adaptive enhancement for Medicaid reimbursement under SHARS specialized transportation. Specialized transportation services reimbursable under SHARS requires the Medicaid-eligible special education student has the following documented in his or her IEP:
•The student requires a specific physical adaptation or adaptations of a vehicle in order to be transported.
•The reason why the student needs the specialized transportation.
Children with special education needs who ride the regular school bus to school with other nondisabled children are not required to have the transportation services in a school setting listed in their IEP. Also, the cost of the regular school bus ride cannot be billed to SHARS. Therefore, the fact that a child may receive a service through SHARS does not necessarily mean that the transportation services in a school setting would be reimbursed for them.
Reimbursement for covered transportation services is on a student one-way trip basis. The following one-way trips may be billed if the student receives a billable SHARS service (including personal care services on the bus) and is transported on the school's specially adapted vehicle from:
•The student's residence to school.
•The school to the student's residence.
•The student's residence to a provider's office that is contracted with the district.
•A provider's office that is contracted with the district to the student's residence.
•The school to a provider's office that is contracted with the district.
•A provider's office that is contracted with the district to the student's school.
•The school to another campus to receive a billable SHARS service.
•The campus where the student received a billable SHARS service back to the student's school.
Covered transportation services from a child's residence to school and return are not reimbursable if, on the day the child is transported, the child does not receive a Medicaid-covered SHARS service (other than transportation). Documentation of each one-way trip provided must be maintained by the school district (e.g., trip log). This service must not be billed by default simply because the student is transported on a specially-adapted bus.
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