“Informed consent is agreement to do something or to allow something to happen only after all the relevant facts are disclosed.”
Prospective Consent – Consent for future services/billing.
Targeted Distribution – Consent is applicable to a child receiving eligible special education services and who has been identified as Medicaid eligible.
Annual Notice – Annual opportunity to discuss SHARS.
Special Education Referral is not a Medicaid Referral
Not all SLPs need a NPI number
Medicaid Referral for SI and AI (every 3-years)
Written document requesting evaluation for services.
- Medicaid referring physician or audiologist / SLP must have an individual NPI number & TX Medicaid registration
- Physician = referral or prescription for SI/AI
- SLP / AI = referral for SI/AI
NPI, printed name, signature with date on the referral (or SI or AI evaluation if SLP number is used)
NPI on claim submission and with SHARS records
Personal Care Services
Q: What is SHARS PCS?
A: Depends on the individual student
Things to consider when deciding if the time you are reporting is SHARS PCS:
- No difference between setting
- Certified Orientation and Mobility Specialist (COMS) services
- Teacher of students with visual impairments
- Behavioral Examples
- Is the behavior age appropriate?
- Is the behavior linked to a behavior disability?
- Is the time primarily instruction/curriculum?
- Is the PCS time predictive?
What is NOT SHARS PCS?
- Activities a typical developing child can do
- Potty training
- Braille instruction
- Sign Interpreter
- Functional Curriculum (is not SHARS PCS)
- Teaching a self-contained class
- Cueing educational tasks
- Observation / stand by supervision
Service Documentation – Evaluations & Assessment
Evaluations – OT, PT, Speech, Psychology
Documentation Must Include – Student name, DOB, Medicaid number on every page with student name, Date of service, Start/End time of session, Total Billable Minutes, Observations, Procedure Code, Specific Activity Performed, Provider printed name, Title and Signature with date
Therapy – OT, PT, Speech, Audiology, Counseling/Psychological Services
Documentation Must Include – Student name, DOB, Medicaid number on every page with student name, Date of service, Start/End time of session, Total Billable Minutes, Observations, Procedure Code, Individual or Group setting, Specific Activity Performed, IEP Goal applicable to the session, Student progress (if applicable), Reason for co-treatment (if applicable), Provider printed name, Title and Signature with date