Beginning November 1, 2022, interim claims for School Health and Related Services (SHARS) physical therapy (PT), occupational therapy (OT), speech therapy (ST), and audiology services will be rejected if the billing provider does not include the referring or prescribing provider’s National Provider Identifier (NPI) on the claim.
There is a delay in processing provider enrollment applications for SHARS speech language pathologists (SLPs) and audiologists who would like to serve as a referring provider for SHARS SLP and audiology services, respectively. Providers experiencing a delay are encouraged to reach out to designated TMHP staff at firstname.lastname@example.org for enrollment application status updates.
Claims for dates of service on or after November 1, 2022, will be eligible for reimbursement after the provider enrollment process is complete if a provider submits an enrollment application before November 1, 2022, completes provider enrollment prior to the claim submission, and adheres to timely claim filing deadlines throughout the enrollment process.
SHARS billing providers must submit claims requiring the NPI of a newly enrolled SLP or audiologist within 95 days of the date that enrollment is complete and within 365 days of the date of service.
For more information, call the TMHP Contact Center at 800-925-9126.