S.  PHYSICIAN SERVICES

S1. What do districts most commonly bill under physician services?

The most common claim for physician services involves obtaining prescriptions/referrals that Medicaid requires for physical therapy and occupational therapy services.

S2. Does the doctor need to see the student?

Whether or not the physician sees the student while reviewing records for writing a prescription/referral is left up to the professional judgment of the physician. The physician is ultimately responsible for the services he/she prescribes; and therefore, the decision for the level of review must be left up to the physician.

See also response to C2.

S3. Can districts bill for a physician's services if the physician does not charge the district for his/her services?

Yes, it is permissible for school districts to bill for SHARS even if a physician does not charge the school district for his or her services.  That physician must still participate in the RMTS for the services to be billed to SHARS. However, if the physician is not included on the RMTS participant list for the school district, that physician's services cannot be billed to Medicaid.

S4. May assessments for students with visual impairments be billed under SHARS physician services?

Visual screenings cannot be billed by a SHARS provider, as it is not a SHARS service. See also response to J9.