Teleservices: What You Need to Know

What is and isn’t considered teleservice? What is billable through SHARS in light of virtual support? These questions may seem cut and dry but they aren’t. There are multiple terms and meanings used when it comes to services delivered remotely, and you should be familiar with them. Terms such as telehealth, teleservice, and telemedicine all boil down to delivering services when both parties are in different physical locations.

Synchronous and Asynchronous Service Explained

Remote services can include support via phone, email, webinar, mail, fax, mobile phone, internet, etc. When we think about the specifics of such services, we tend to think in two camps: synchronous and asynchronous. This idea of synchronous and asynchronous, while new for most of us, boils down to the modality we use to deliver services either virtually or offline.

• Synchronous service is that which, through a variety of means, allows us to work together with another person(s) at the same time.
• Asynchronous service, as the word sounds, is the relay of information with a time lag.

At our SHARS 2020 conference, we discussed some pros and cons of both. The presentation is available on our website.

SHARS Billing for Telehealth Services

In the context we most often talk to clients about, SHARS, telehealth is more narrowly defined for those that provide remote telehealth services overall. TEA has made it clear (pdf) that the level and type of support provided is a local determination, and for students in special education, this is made in conjunction with the families we serve. In SHARS, teleservices are only billable in approved categories when delivered with real-time interactivity with the student. The Texas Medicaid and Healthcare Partnership (TMHP) Telecommunication Services Handbooks (pdf) allows for billing of:

• Synchronous audiovisual interaction
• Asynchronous media is combined with synchronous audiovisual interaction
• Other forms of audiovisual telecommunication technologies

The bottom line for SHARS is that there must be two-way, real-time interactive communication where the therapist sees the student. This can be via multiple mediums including a mobile device, tablet, computer, etc. We have a teleservices primer handout (pdf) and presentation (pdf) you can use with your staff to help.

Teleservices come in different flavors and with a language all its own. While nearly all of us have jumped in the deep end of remote supports during this pandemic, we have done so primarily as we sought to meet the needs of the students, families, and communities we serve. Educators, the new superheroes among us, have nimbly traversed the challenges. Service delivery billable under the SHARS program certainly adds a layer of complexity. With some forethought, the standard is not insurmountable.