M.  COUNSELING SERVICES

M1. Are counseling services provided by a TEA or SBEC-certified counselors billable under SHARS?

No. Effective September 1, 2006, TEA- or SBEC-certified counselors are not listed as an approved licensed provider in the Texas Medicaid State Plan for SHARS and their services are not billable. Only counseling provided by a licensed professional counselor (LPC); licensed clinical social worker (LCSW, formerly LMSW-ACP); or a licensed marriage and family therapist (LMFT) should be billed under the procedure codes for counseling.

Counseling or testing services provided by a licensed specialist in school psychology (LSSP); licensed psychologist; or licensed psychiatrist should be billed under the procedure codes for psychological services.

M2. May temporary licensed professional counselors (LPCs) bill for SHARS?

Yes, counseling services rendered by an LPC or other qualified behavioral health professionals approved in the Texas Medicaid State Plan for SHARS, who have been issued a temporary license may be billed as long as the services were rendered in accordance with their Texas licensure requirements.

M3. May an LPC intern or LSSP Intern who is supervised by his/her school district supervisor bill for SHARS under the psychological procedure codes (96152- AH or 96153-AH) codes?

No, according to the Billing Guidelines, the LPC Intern or LSSP Intern may not bill SHARS under the psychological procedure codes because they are not listed as an approved licensed provider in the Texas Medicaid State Plan for SHARS.

NOTE: All interns other than SLP interns cannot bill for their services.

M4. If a district employs a school counselor (NOT a licensed LPC or LSSP) to provide special education counseling services, should they claim those counseling IEPs in their IEP Ratio Count?

Yes, the IEP Ratio is the (total number of Medicaid students with IEPs requiring direct medical services) / (total number of students with IEPs requiring direct medical services). As long as the student has a valid IEP that documents the need for direct medical services, they are to be included in the IEP Ratio count.