P.  OCCUPATIONAL THERAPY

P1. Can an OT bill for assistive technology training or assistive technology evaluations?

Yes.  Districts can bill SHARS for OT evaluation, therapy, training and fitting associated with such devices.  The licensed OT can perform the evaluation. The licensed OT or the OT assistant can provide the treatment services.  There are two procedure codes for SHARS OT services, one is the procedure code for the evaluation and one set of procedure codes is for the treatment services. There are more OT procedure codes available in the nonschool setting. All those OT services are billable for SHARS under the appropriate procedure codes. See also the current TMPPM section on SHARS.

P2. May school districts bill for a licensed provider providing direct service through demonstration of therapeutic activity to teach a non-licensed provider how to assist the student in the classroom?

Yes, it is a billable SHARS service for PT and OT, provided it is included in the IEP and the student is an active participant

P3. If the frequency/duration does not change from year to year, only minimal change in the IEP goals/objectives, would a “new” prescription be required? Generally, goals/objectives change from school year to school year and we know the prescription is valid for 3 years unless the IEP changes. What specifically constitutes “a change” in the IEP with regards to PT/OT?

The “change in the IEP” means that there is a change in the plan of care for these services.  This in turn, would mean that an evaluation or reevaluation has been done for the student.  If an evaluation or reevaluation results in a change in the plan of care for services, that results in a change to the goals and objectives for OT services and the frequency and duration of service remain the same, a new physician's script is not required. However, if the frequency and/or duration of OT service changes, then a new physician's script is required.  If there are no changes to the prescription, the expiration date for the physician prescription is the earlier of either the physician’s designated expiration date on the prescription or three years, in accordance with the IDEA three-year re-evaluation requirement.

P4. Can a Nurse practitioner bill for OT or PT services?

No, both OT and PT providers must meet certain certification/licensure requirements in order for the services they provide to be payable through the SHARS program. OT services must be provided by a professional who is licensed by the Texas Board of Occupational Therapy Examiners or a certified occupational therapy assistant acting under the supervision of a qualified occupational therapist. PT services must be provided by a professional who is licensed by the Texas Board of Physical Therapy Examiners or a licensed physical therapist assistant (LPTA) acting under the supervision of a qualified physical therapist.