Parental Consents

“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.

 

Speech Referrals

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
• Restraint
• 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