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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 3. School Health and Related Services (SHARS) : 3.3 Services/Benefits, Limitations, and Prior Authorization : 3.3.4 Nursing Services

Nursing services are skilled nursing tasks, as defined by the Texas Board of Nursing (BON), that are included in the student’s IEP. Nursing services may be direct nursing care or medication administration. Examples of reimbursable nursing services include, but are not limited to, the following:
Direct nursing care services are billed in 15‑minute increments and medication administration is reimbursed on a per-visit increment. The RN or APRN determines whether these services must be billed as direct nursing care or medication administration.
Nursing services must be provided by an RN, an APRN (including nurse practitioners [NPs] and clinical nurse specialists [CNSs]), licensed vocational nurse/licensed practical nurse (LVN/LPN), or a school health aide or other trained, unlicensed assistive person delegated by an RN or APRN.
Nursing services are billable on an individual or group basis. Only the time spent with the student present is billable. Time spent without the student present is not billable. Session notes are not required for nursing services; however, documentation must include the billable start time, billable stop time, total billable minutes, and must note the type of nursing service that was performed.

Texas Medicaid & Healthcare Partnership
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