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On June 18th, the Texas Education Agency notified stakeholders of draft changes to SHARS policy. Policy updates are now complete and will be effective on 10/1/2024.
An overview of SHARS policy changes to medical benefits include the following:
- Clarification of nurse-delegated tasks
- Procedure code update for physical services
- Clarificaiton of speech therapy referrals
- Updated benefit information for personal care services (PCS) for the following:
- Defined areas of required provider competency, with documentation requirement effective October 1, 2025
- Clarified that PCS may be provided in a group setting, but the time that the provider assists one student must not overlap with the time that the provider works with another student
- Removed group PCS modifier UD
- Clarified definition of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)
- Added descriptions of specific activities included in ADLs and IADLs
- Added requirement to record the total billable minutes per day for each ADL and IADL provided
- Revised reimbursement guidelines and requirements to align with
Texas Administrative Code (TAC) Title 1 §355.8443
A full description of changes and updates are available for review on the TMHP Webpage.
Please email questions to HHSC SHARS Medical Policy at MedicaidBenefitRequest@hhsc.state.tx.us.
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