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Five Steps to Becoming a School Health and Related Services (SHARS) Medicaid Provider

The SHARS program provides Texas school districts, including public charter schools, the opportunity to obtain Medicaid reimbursement for direct medical services and certain costs associated with direct medical services provided to students with special needs under the Individuals with Disabilities Education Act (IDEA) and documented in a student's Individualized Education Program (IEP). The oversight of SHARS is a cooperative effort between the Texas Education Agency (TEA) and Health and Human Services Commission (HHSC).

  1. Enrollment. The district must enroll as an active Medicaid provider for SHARS. For more information on enrolling as a Medicaid provider, instructions for becoming a Texas Medicaid fee-for-service provider are available on the Texas Medicaid and Healthcare Partnership (TMHP) website at:

    For assistance with enrollment please contact the SHARS Rate Analysts at (512) 730-7400 or
  2. Random Moment Time Study (RMTS). In order to participate in SHARS each district must participate in RMTS, which includes attending RMTS training annually and submitting participant lists quarterly. Existing districts must begin participation with the first quarter which requires training attendance and participation list submission no later than September 15th annually. Non-compliance with RMTS requirements will make an ISD ineligible to participate in SHARS for the entire federal fiscal year (October to September). Participation and training requirements related to RMTS.

    For assistance with participation in RMTS contact RMTS staff at the number on the Contacts List or
  3. Rates. School districts providing SHARS are paid on an interim claiming basis using SHARS interim rates. After a district has completed the RMTS requirements and the enrollment process a district must contact the SHARS staff at the number on the Contacts List or to have SHARS interim rates established.
  4. Billing. According to Title 1 of the Texas Administrative Code (TAC) §354.1342 a district must bill. After items 1, 2, and 3 above have been completed, the district can begin billing through TMHP for federal reimbursement. If a district fails to bill during a cost report period the district is not eligible to submit a SHARS Cost Report. Information regarding billing is available in the Texas Medicaid Provider Procedures Manual (TMPPM) located at:

    For assistance with billing contact your TMHP Provider Relations Representative at 1-800-925-9126.
  5. Cost Report. According to the Reimbursement Methodology rules for SHARS Title 1 of the TAC §355.8443 districts must submit an accurate and complete cost report each year in which the district actively participates in SHARS. Failure to submit a cost report is grounds for recoupment of all interim federal funds received during the cost report period in which the default occurs. Additional training requirements and guidance documents related to the SHARS Cost Report.

    For assistance with the cost report contact SHARS staff at the number on the Contacts List or