Proposed Medicaid Payment Rates for School Health and Related Services (SHARS)

Policy
July 30, 2024
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Hearing. The Texas Health and Human Services Commission (HHSC) conducted a public hearing to receive public comments on proposed Medicaid Payment Rates for School Health and Related Services (SHARS) reimbursement methodology. Proposal. The effective date of the proposed payment rates for the topics presented during the rate hearing will be as follows: Proposed to be effective October 1, 2024: SHARS Rate Methodology Remove UD group modifier for Personal Care Services (PCS) code T1019 in SHARS Replace the current Physician Services code (99499) with screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter (T1023).  Methodology and Justification. The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code: Section 355.8443, Reimbursement Methodology for School and Related Services (SHARS) SHARS Rate Adjustments (Propo

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