U.  SPECIALIZED TRANSPORTATION SERVICES

U1. When can specialized transportation be billed for SHARS?

Specialized transportation service may be Medicaid reimbursable if:

  • it is being provided to and from a Medicaid covered (SHARS) service(s) for the day the claim is made;
  • the Medicaid covered service(s) is included in the student's IEP;
  • the specialized transportation needs are included in the IEP (must include the type of adaptation that is required on the vehicle and why the student needs/requires that adaptation), and
  • the child requires transportation in a school bus adapted to serve the needs of a student with a disability.

On a day when the student receives a related Medicaid-covered SHARS service, specialized transportation services may be provided and can include coverage of transportation in the following instances from:

  • student's residence to school;
  • school to student's residence;
  • student's residence to a provider's office that is contracted with the district;
  • a provider's office that is contracted with the district to the student's residence;
  • school to a provider's office that is contracted with the district; 
  • a provider's office that is contracted with the district to the student's school;
  • school to another campus to receive a billable SHARS service; or
  • the campus where the student received the SHARS service back to the student’s school.

Specialized transportation services from a child's residence to school and return will not be Medicaid reimbursable if, on the day the child is transported, the child does not receive a Medicaid-covered SHARS service other than transportation to the school location.

Documentation of each specialized transportation service provided must be maintained. This documentation may take the form of a trip log. This service must not be billed by default.

 See also Billing Guidelines on the TEA website (refer to the billing guidelines section), and the current TMPPM section on SHARS.

U2. Can districts bill for one-way transports?

Yes, specialized transportation must be billed on a one-way-trip basis. (Effective 9/1/2004 specialized transportation is no longer reimbursable on a round-trip basis.)

U3. When can a school district receive reimbursement for specialized transportation? Specifically, a bus is bought with state funds to transport special education students, federal funds are used to add a lift, and the driver is paid out of federal funds? Can these districts still bill for specialized transportation?

The school district may bill for specialized transportation for eligible students whose IEP includes transportation on a specially adapted vehicle and who receive a related SHARS service on the same day.  The IEP must include the type of adaptation that is required on the vehicle and why the student needs/requires that adaptation. A specially adapted vehicle is one that has been physically modified (e.g. addition of a wheelchair lift, addition of seatbelts or harnesses, addition of child protective seating, or addition of air conditioning).

 See also Billing Guidelines on the TEA website (refer to the billing guidelines section), and the current TMPPM section on SHARS.

U4. Is air conditioning considered adaptive equipment?

Yes, if this is included in the IEP as a need for an individual student. However, if all buses in the school district are air-conditioned, then this is not considered a special adaptation.

See also responses to U1 and U3.

U5. All of the buses are fitted with seatbelts that were ordered at factory or have been added to the vehicles after purchase. Since the seatbelts are not standard equipment, and were a special order item, is this considered an adaptive equipment?

No. If the intent of the district is to order buses, from now on, with seatbelts, this is not a special adaptation. If the intent is to identify special education students that require seatbelts and use these buses only for those kids, this is also not a special adaptation.

U6. Please explain the major change that no longer makes riding in an “adapted” vehicle sufficient?

In order to bill for specialized transportation, the child must be transported in a specially adapted district-owned or district-contracted vehicle.  Specially adapted means a vehicle that has physical adaptations not normally found on a regular school bus.  For example, the vehicle might have a wheelchair lift, harnesses, child-protective seating, or is air conditioned. The presence of a bus monitor does not meet the criteria of a special adaptation.

U7. What if there is a monitor on the bus?

The presence of a bus monitor will no longer be considered a special adaptation. More than likely, the bus monitor services could be billable as “Personal Care Services on the Bus” assuming the appropriate documentation is maintained and the personal care service is in the student’s IEP.

U8. What are the minimum requirements for transportation logs?

At a minimum, the transportation log should include:

  • The SHARS provider name (i.e., school district name)
  • First Name and Last Name of each student for each trip, along with each student's ID
  • One log per vehicle, indicating the route name/number [with documentation maintained somewhere that describes each route/trip as to the start and stop locations ]
  • Method for identifying the number of one-way trips per day (e.g., AM and PM trips) [with documentation maintained somewhere that describes the times for each trip] -- Remember that the number of one-way specialized transportation trips must be counted for calculating the one-way trip ratio for allocating specialized transportation costs to the Medicaid program.
  • Method for personal care services (PCS) provider, transportation aide, bus monitor, or assistant to verify own attendance for each trip and include a place for this person to sign and date the form.
  • Method for driver to verify own attendance for each trip and include a place for this person to sign and date the form.
  • Method for nurse to verify own attendance for each trip and include a place for this person to sign and date the form.
  • The log can be maintained per day and for several days, with applicable dates noted on the log.
  • Mileage needs to be maintained somewhere; but, not on the log.

 See also Billing Guidelines on the TEA website (refer to the billing guidelines section), and the current TMPPM section on SHARS.

U9. What signatures or initialing are required to be maintained for documenting the specialized transportation service provided?

The minimum requirements for transportation logs are outlined in U7. The transportation log can be every day, weekly, monthly --- just not annually. For daily transportation logs, the bus driver needs to sign and date the log.

Any nurse, PCS attendant, etc. that provided a service during the bus ride or transportation service can verify his/her own attendance for each trip by initialing the transportation log on the day of the service.  The finalized log (log can be every day, weekly, monthly --- just not annually) needs to be signed by the bus driver and the people that initialed their attendance on the bus that provided a service (PCS person, nurse, etc.).

U10. The district has a student who attends school only 2 hours per day and is on homebound for the remainder of the student’s instruction time. The student’s father is paid to transport the student to and from school and to and from physical therapy in another town. The medical need for specialized transportation services are documented in the student’s IEP and the vehicle the student is transported in (owned by the parent) is specially adapted. Can the school bill for the specialized transportation services for this student?

Yes, if the student has an accompanying SHARS service on the day the specialized transportation is provided then the district can bill SHARS for the specialized transportation service for the student:

  • when the student is transported in a vehicle (owned by the parent) and
  • the vehicle the student is transported in is specially adapted.

U11. We reported the wrong cost of a vehicle in Step 4E our cost report this year because it was not reported correctly the previous year, how do I fix this?

You need to first remove the asset from service in the current cost report. When the previous year’s cost report is in the Settlement Process, you will need to request an informal review to remove the asset and re-enter it with the correct historical values. Only assets costing $5,000 and over should be depreciated, anything less should be expensed accordingly.