As of November 1, 2022 a referral was required for audiology and speech therapy services to be reimbursed through the School Health and Related Services (SHARS) program, affecting many speech-language pathologists (SLPs) and Audiologists working in a school setting. With this new policy, SLPs and Audiologists could serve as referring providers as long as they were enrolled as individual Medicaid practitioners. 

As of August 2023, there has been an update to the Texas Medicaid and Healthcare Partnership (TMHP) Procedures manual for SHARS where SLPs and Audiologists could serve as the referral source if they were enrolled in Medicaid as individual practitioners OR as Ordering, Referring, Prescribing (ORP) providers.

There are a few benefits to the ORP enrollment for SLPs/Audiologists that ONLY work in the school setting: 

1. The application is less complex and doesn't require filling out W-9/accounting documents 
2. The ORP application will not go to an inactive status like an individual practitioner enrollment would if there are not any claims submitted for 2 years. 

The TSHA Public School Advisory Committee recommends the following course of action for individuals based on these updated guidelines from TMHP:

• SLPs/Audiologists who are not enrolled in Medicaid and will be serving as a referral source for SHARS
  • Complete ORP Enrollment
• SLPs/Audiologists who are enrolled as individual practitioners to serve as a referring provider for SHARS and do not work in any other setting with Medicaid 
  • Disenroll as individual practitioners and enroll as ORP providers
• SLPs/Audiologists who are enrolled as individual practitioners and actively submits claims (in another setting)
  • Do nothing with Medicaid enrollment status - keep individual practitioner status