SHARS Program Updates for the 2024 School Year

By Dario Avila, senior consultant TASB Special Education Solutions

School-based Medicaid programs, including Texas’ own School Health and Related Services (SHARS) program, often can be complicated and confusing. Following is a summary of some of the items discussed in a recent TASB Special Education Solutions webinar regarding recent SHARS policy updates.



  • As of July 3, 2023, Speech Language Pathologists needing to enroll as Texas Medicaid providers to provide referrals for Speech Therapy services now have the option of enrolling as Ordering, Referring, Prescribing (ORP) Providers.
  • The Health and Human Services Commission has yet to receive approval from Centers for Medicare & Medicaid Services (CMS) for Audiology services prescribed in a student’s Section 504 Plan to be reimbursable through SHARS.
  • The new school-based Medicaid guide issued by CMS highlights several new flexibilities that states can take advantage of to make school-based Medicaid easier for districts. Texas leaders have yet to announce their intent to adopt any of the changes to SHARS as they are still researching the impact of any potential program changes to our Texas districts.
  • For the first time, this year’s Random Moment Time Study, conducted for the SHARS program, will include a fourth quarter time study. As this has never been done before in Texas, it is unknown how this will impact the direct medical time study percentage that is calculated by the study and used in the SHARS reconciliation process.

To stay up-to-date on all things SHARS, sign up for TASB’s SHARS Matters newsletter.

To view and register for any of the upcoming TASB SHARS Matters Webinars, please visit the TASB Special Education Solutions Training page.

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