Frequently Asked Questions
If a child receives Medicaid billable services at school under the SHARS program, are they also able to receive the same service through Medicaid outside of the regular school hours?
Yes, the child's eligibility for, or amount of, Medicaid services outside the school setting is not compromised by receiving SHARS at school. Although all Medicaid services must be medically necessary, the services provided at school under the SHARS program are also necessary for the child to receive a free and appropriate public education. However, due to medical necessity alone, the child may need additional Medicaid services outside of school. For example, a school may provide and bill for SHARS speech therapy for a student who also receives speech therapy from a different Medicaid provider outside the school setting.
Could billing SHARS cause a child to exceed any "cap" or lifetime maximum on their Medicaid benefits?
There is no lifetime benefit cap for Medicaid services for children 20 years of age or younger. SHARS is a program under the EPSDT (Early and Periodic Screening, Diagnosis and Treatment) program. Under EPSDT, there are no set limitations or caps on Medicaid services for clients 20 years of age or younger, so long as the services are medically necessary. The Medicaid services the child receives at school do not affect the type or amount of Medicaid services the child receives outside of school.
Will the services received under SHARS impact other Medicaid services prescribed by my primary physician?
The Medicaid services the child receives at school do not affect the type or amount of Medicaid services the child receives outside of school.