State Administrator Guide
Overview
As a State Administrator, you manage the global configuration that drives the entire eSHARS system across all Texas school districts. Your configurations define what services can be documented, who can provide them, and how they are billed.
Your Responsibilities
| Area | What You Manage |
|---|---|
| Global Services | Define all billable service types |
| Service Categories | Organize services into categories |
| Qualifications | Define provider qualification types |
| Global Settings | System-wide configuration |
| District Oversight | Monitor all districts |
Navigation
State Admin functions are accessed via the top navigation bar:
| Menu | Purpose |
|---|---|
| GLOBAL DATA | Services, categories, qualifications, codes |
| DATA MGMT | Data management utilities |
| EDI MGMT | EDI configuration and monitoring |
| IMPORTS | Batch import management |
| JOBS | Background job monitoring |
| AUDIT LOG | System audit trail |
| SA SUBMITTALS | Signature authorization management |
| REPORTS | State-level reporting |
| SECURITY | User and role management |
| AD-HOC REPORTS | Custom reporting |
| FINANCE | Financial oversight |
Global Services Configuration
Global Services is the master catalog of all billable services in eSHARS. Each service definition controls what clinicians can document and how visits are billed to Medicaid.
Accessing Global Services
- Click GLOBAL DATA in the top navigation
- Select Global Services
- Use the left panel to browse services by category
- Click a service to view/edit its configuration
Service Configuration Tabs
Each service has 9 configuration tabs:
Tab 1: DETAILS
Basic service identification and settings.
| Field | Description | Example |
|---|---|---|
| Service Name | Full service name | AU Eval (504) Comprehensive Audiometry Threshold and Sp Recognition-Both Ears |
| Diagnosis Code | ICD-10 diagnosis code | F81.9 |
| Code | Internal service code | AUE57-P5 |
| Service Option | ARD linkage | No ARD, With ARD |
| Activation Date | When service becomes available | 10/1/2024 |
| Deactivation Date | When service expires | 1/1/2050 |
| Billing Type | Individual or Group | Individual |
| Category | Service category | Audiological Evaluation |
| Form | Visit form template | Audiology Evaluation |
| Service Mins | Duration options | N/A, Service Mins, Service Mins Range |
Key Decisions:
- Service Option: “No ARD” for services not tied to IEP hours; “With ARD” for services that deduct from allocated hours
- Billing Type: “Individual” for one-on-one services; “Group” for services delivered to multiple students
- Form: Determines the visit documentation form clinicians will complete
Tab 2: ENFORCE RULES
Business rules that control visit validation and compliance.
| Rule | Description | Values |
|---|---|---|
| Prescription Required | Requires valid prescription before visit | Yes/No |
| Restrict Duplicate Same Time | Prevents same service at same time for student | Yes/No |
| Enforce Caseload Check | Requires student on clinician’s caseload | Yes/No |
| Can Be Copied | Allows visit copying functionality | Yes/No |
| Billed Outside Business Hours | Allows extended hours billing | Yes/No |
| Session Note Required | Requires clinical notes | Yes/No |
| Is Trip Based | Service is transportation-based | Yes/No |
| Restrict Duplicate Same Time For Provider | Prevents provider from documenting overlapping visits | Yes/No |
Rule Configuration:
- Each rule has Start Date and End Date for effective dating
- Rules can change over time without modifying historical data
- Multiple rule versions can exist for audit purposes
Common Configurations:
| Service Type | RX Required | Caseload Check | Trip Based |
|---|---|---|---|
| Therapy (OT/PT/Speech) | Yes | Yes | No |
| Transportation | No | No | Yes |
| Nursing | Yes | Yes | No |
| Assessment/Evaluation | Yes | No | No |
Tab 3: MAX MINS/MAX TRIPS
Billing limits to prevent over-billing.
| Field | Description | Example |
|---|---|---|
| Organization | Scope (State, District) | Texas State |
| Maximum Minutes Billable | Max minutes per period | 0 (unlimited), 60, 120 |
| Maximum Trips Billable | Max trips per period | 1, 2 |
| Billing Limit Duration Type | Period type | Day, Week, Month, Year |
| Start/End Date | Effective period | 10/01/2022 - 12/31/2049 |
Use Cases:
- Transportation: Max 2 trips per day (AM and PM)
- Evaluations: Max 1 per day
- Therapy sessions: May have no limit (0) or daily caps
Organization Hierarchy:
- State-level limits apply to all districts
- District-level limits can be more restrictive than state
- Most restrictive limit applies
Tab 4: QUALIFICATIONS
Defines which provider qualifications can deliver this service.
| Field | Description | Example |
|---|---|---|
| Qualification | Provider qualification type | AU Therapist_Audiology |
| Code | Qualification code | UA |
| Billing Code 1 | Primary billing code | AUE57-P5 |
| Delegated Billing Code | For supervised providers | (optional) |
| Active | Currently valid | Yes/No |
| Start/End Date | Effective period | 08/31/2020 - 01/01/2050 |
| Grace Period | Days after end date for backdating | 30 |
| Visit Creation End Date | Last date to create visits | 01/31/2050 |
| Proc. Code 1 | CPT procedure code | 92557 |
| Proc. Code 2 | Secondary procedure code | (optional) |
| Mod. Code 1 | Modifier code | U4 |
| Mod. Code 2 | Secondary modifier | (optional) |
Key Concepts:
- A service can have multiple qualified provider types
- Each qualification can have different billing codes
- Grace period allows visit backdating after qualification expires
- Procedure and modifier codes are sent to Medicaid
Example - Speech Therapy Service:
| Qualification | Code | Proc Code | Modifier |
|---|---|---|---|
| Speech Therapist | ST | 92507 | U4 |
| Speech Assistant | STA | 92507 | U5 |
Tab 5: BILLING INFO
Unit conversion rules for billing.
| Field | Description | Example |
|---|---|---|
| Mins to Unit Number | Minutes per billing unit | 15 |
| Unit Round Up Number | Rounding threshold | 8 |
| Minimum Billable Unit | Minimum units to bill | 1 |
| Billing Code Type | Code classification | Standard, HCPCS |
| Service Billing Start/End Date | Effective period | Date range |
Unit Conversion Example:
- 15 mins = 1 unit
- Round up at 8 mins
- 23 mins = 2 units (15 + 8)
- 22 mins = 1 unit (15 + 7, doesn’t round)
Tab 6: RATE
Reimbursement rates by date range.
| Field | Description | Example |
|---|---|---|
| Rate Start Date | Effective from | 10/01/2024 |
| Rate End Date | Effective until | 09/30/2025 |
| Rate | Dollar amount per unit | $45.50 |
Rate Management:
- Rates change annually (typically October 1)
- Historical rates preserved for reporting
- Used in revenue projections and cost reporting
Tab 7: ACTIVITIES
Sub-activities within a service for detailed documentation.
| Field | Description | Example |
|---|---|---|
| Activity Name | Activity description | Fine Motor Skills |
| Is Billable? | Contributes to billing | Yes/No |
| Repeatable in Single Visit? | Can document multiple times | Yes/No |
Use Cases:
- Therapy services may have multiple activity areas
- Allows granular documentation while maintaining single service billing
Tab 8: DISTRICT
Controls which districts can offer this service.
| Field | Description |
|---|---|
| District Name | District name |
| Is Service Offered | Enable/disable for district |
Management:
- By default, services are offered to all districts
- Disable for districts that don’t provide specific services
- Useful for specialized services only certain districts offer
Tab 9: RESTRICTIONS
Prevents conflicting services from being billed together.
| Field | Description |
|---|---|
| Restricted Service Name | Service that cannot be billed with this one |
| Restriction Type | Type of restriction |
Restriction Types:
- Same Day: Cannot bill both on same day
- Same Time: Cannot bill both at same time
- Same Session: Cannot bill both in same session
Example:
- Individual Speech Therapy restricted with Group Speech Therapy on same day
Service Categories
Categories organize services for navigation and reporting.
Managing Categories
- Go to GLOBAL DATA → Categories
- View existing categories (Assessment, Audiological, Nursing, OT, PT, Speech, etc.)
- Click + Add to create new category
- Assign services to categories via Service DETAILS tab
Standard Categories
| Category | Description | Service Count |
|---|---|---|
| Assessment | Evaluations and assessments | ~20 |
| Audiological Evaluation | Hearing-related services | ~15 |
| Nursing | School nursing services | ~10 |
| Occupational Therapy | OT services | ~25 |
| Physical Therapy | PT services | ~20 |
| Psychological | Psychological services | ~15 |
| Speech Therapy | Speech/language services | ~30 |
| Transportation | Special transportation | ~5 |
| Personal Care | Personal care services | ~10 |
Qualifications Management
Qualifications define what services a provider can deliver based on their credentials.
Managing Qualifications
- Go to GLOBAL DATA → Qualifications
- View/edit existing qualifications
- Link qualifications to services via Service QUALIFICATIONS tab
Standard Qualifications
| Code | Qualification | Services |
|---|---|---|
| OT | Occupational Therapist | OT services |
| OTA | OT Assistant | OT services (supervised) |
| PT | Physical Therapist | PT services |
| PTA | PT Assistant | PT services (supervised) |
| ST | Speech Therapist | Speech services |
| STA | Speech Assistant | Speech services (supervised) |
| RN | Registered Nurse | Nursing services |
| LVN | Licensed Vocational Nurse | Nursing services |
| AU | Audiologist | Audiology services |
| PSY | Psychologist | Psychological services |
Creating a New Service
Step-by-Step Process
-
Plan the Service
- Determine service category
- Identify billing codes (CPT, HCPCS)
- Define qualified provider types
- Determine business rules
-
Create Service
- Go to GLOBAL DATA → Global Services
- Click + Add New Service
- Complete DETAILS tab
- Save
-
Configure Rules
- Go to ENFORCE RULES tab
- Add each rule with effective dates
- Save each rule
-
Set Billing Limits
- Go to MAX MINS/MAX TRIPS tab
- Add limits if applicable
- Save
-
Add Qualifications
- Go to QUALIFICATIONS tab
- Add each qualified provider type
- Include procedure and modifier codes
- Save
-
Configure Billing
- Go to BILLING INFO tab (if unit-based)
- Set unit conversion rules
- Save
-
Set Rates
- Go to RATE tab
- Add reimbursement rate
- Save
-
Enable Districts
- Go to DISTRICT tab
- Verify service is offered to correct districts
- Disable for districts that don’t need it
-
Add Restrictions
- Go to RESTRICTIONS tab (if applicable)
- Add conflicting services
- Save
-
Test
- Log in as clinician with appropriate qualification
- Verify service appears in visit creation
- Create test visit
- Verify validation rules work
Common Administrative Tasks
Task: Update Procedure Codes for New Fiscal Year
- Go to GLOBAL DATA → Global Services
- For each affected service:
- Go to QUALIFICATIONS tab
- Edit qualification record
- Update procedure/modifier codes
- Set new effective dates
- Save
Task: Add New District to System
- Create district in DATA MGMT → Districts
- Review all services in GLOBAL DATA → Global Services
- Enable services for new district via DISTRICT tab
- Configure district-specific settings
Task: Deactivate a Service
- Go to service DETAILS tab
- Set Deactivation Date to effective date
- Service will no longer appear for new visits after that date
- Historical visits remain unaffected
Task: Change Billing Limits Mid-Year
- Go to service MAX MINS/MAX TRIPS tab
- End-date current limit record
- Add new record with new limits and start date
- Both records preserved for audit
Reports for State Admin
| Report | Purpose | Navigation |
|---|---|---|
| Service Utilization | Usage by service type | REPORTS → Service Reports |
| District Comparison | Cross-district metrics | REPORTS → District Reports |
| Provider Compliance | Qualification status | REPORTS → Provider Reports |
| Billing Summary | Statewide billing activity | REPORTS → Billing Reports |
| Audit Trail | Configuration changes | AUDIT LOG |
Best Practices
Service Configuration
- Always use effective dating for rule changes
- Never delete - deactivate instead
- Document reason for changes in internal notes
- Test new services in training environment first
Billing Codes
- Verify codes against current Medicaid fee schedule
- Update codes promptly when TMHP publishes changes
- Maintain historical records for audits
District Management
- Review service offerings annually with each district
- Disable services districts don’t provide
- Monitor utilization for anomalies
Security
- Limit state admin access to essential personnel
- Review audit logs regularly
- Use impersonation carefully and only when necessary
Troubleshooting
”Service not appearing for clinicians”
- Check service activation date (must be current or past)
- Verify district has service enabled (DISTRICT tab)
- Verify clinician has required qualification
- Check qualification effective dates
”Validation errors on visits”
- Review ENFORCE RULES for the service
- Check if student has required prescription (if RX required)
- Verify student is on clinician’s caseload (if enforced)
- Check for duplicate visit restrictions
”Billing codes incorrect”
- Go to service QUALIFICATIONS tab
- Verify procedure and modifier codes
- Check effective dates match visit date
- Update if TMHP has published new codes
Navigation Quick Reference
| Task | Navigation Path |
|---|---|
| Manage Services | GLOBAL DATA → Global Services |
| Manage Categories | GLOBAL DATA → Categories |
| Manage Qualifications | GLOBAL DATA → Qualifications |
| View Audit Log | AUDIT LOG |
| Monitor Jobs | JOBS |
| State Reports | REPORTS |
| User Security | SECURITY |
For district-level administration, see District Admin Guide
For EDI configuration, see EDI Admin Guide