ONWARD News Bulletin
SHARS federal fiscal year (FFY) procedure codes and rates are published annually in October based upon the Cost Report settlements 4-years prior. Generally speaking, procedure codes/rates are only updated on the odd years, though that is not a hard rule. Rates can be billed based upon minutes, encounters, or trips.
This year, several rates and procedure codes methods of calculate changed. Specifically, Onward would like to address Speech therapy. Speech therapy historically paid based upon 15-minute units with a maximum of 4 units. This FFY speech therapy (SLP or SLPA) has changed to a single encounter per day, regardless how many minutes are provided to a student. What does this mean? The district will be paid the same regardless of if a provider renders 1 minute of service or 60 minutes of service.
The rates for therapy have about doubled the previous year rate for group therapy and tripled for individual therapy.
Speech evaluation services are still based upon a 15-minute unit with a maximum of 12 units or 3 hours.
Other categories with this “Untimed” or encounter rate include SOME of the following:
- Psychological Services
The process for the district providers will not change. Providers will continue to document their time; start time, end time, and number of minutes, as required by HHSC. The ONWARD system is designed to know the service is based upon an encounter and cap at one unit.
For more information, please contact your SHARS Account Manager for assistance.