When a RN is provided by the district for a student who needs one-on-one services, can the district bill for the entire day?
All nursing services provided in accordance with the IEP can be billed under SHARS, whether delivered by RN/APN, LVN, or delegation. If nursing services are needed for the entire day, then an entire day’s worth of services may be billed. Time spent away from the student (e.g., breaks or lunch) must be deducted from that RN’s billable time. If those breaks and lunch are serviced by another RN, then the second RN documents that billable time. According to the Billing Guidelines on the TEA SHARS website, nursing services that exceed recommended limits will be denied. Providers can appeal denials by submitting required documentation. Required documentation includes, but is not limited to, showing medical necessity, physician referral, IEP documentation, service log, and actual time spent delivering the service.
