C. PRESCRIPTIONS/REFERRALS

 

C1. Who is authorized to prescribe physical therapy and occupational therapy?

Medical doctors (MDs), doctors of osteopathy (DOs), advanced practice nurses (APNs) with prescriptive authority and physician’s assistants are authorized to prescribe physical therapy (PT) and occupational therapy (OT) services in the SHARS program. PT and OT evaluations are not acceptable as a prescription/referral for SHARS PT or OT services. 

C2. Who can write a referral for speech therapy?

Effective 9/1/2003, SHARS requirements allow for either a medical practitioner (as outlined in C1) or a licensed practitioner of the healing arts to provide the referral for speech therapy. Licensed speech-language pathologists (SLPs) are considered licensed practitioners of the healing arts. The evaluation and recommendation by the SLP may be considered the referral for services.

C3. May the speech evaluation serve as the speech referral?

Yes, if it is clearly documented that the individual who performed the evaluation was a licensed SLP.

C4. Does the student need to be seen by the medical practitioner in order for a SHARS allowable service to be prescribed for him/her? 

Whether or not the authorized medical professional sees the student while reviewing records for writing a prescription is left up to the individual’s professional judgment. The medical practitioner is ultimately responsible for the services he/she prescribes; and therefore, the decision for the level of review must be left up to the medical practitioner.

C5. May a district bill Medicaid for therapy provided prior to the date of the signed referral/prescription?

No, the school district cannot bill Medicaid before the referral/prescription for the services is signed. However, the school district is required to deliver the service per the IEP requirements in accordance with IDEA.

C6. How often must a referral/prescription for physical therapy/occupational therapy or speech therapy services be obtained?

A prescription is required after the initial assessment and must be renewed at least every three years. If the prescription or referral has an end date, the prescription must be renewed prior to the end date. For example, some physicians will only write a prescription that is valid for one year. In addition, when there is a change in the plan of care, a new referral/prescription is needed.

C7. What type of change to the IEP would necessitate a new prescription or referral?

Determinations concerning the need for new prescriptions or referrals are decisions made by the student’s ARD committee. In addition, when there is a change in the plan of care, a new referral/prescription is needed. For example, if the duration time for treatment sessions change or the number of sessions per week change, a new prescription/referral is needed.

C8. If the goals/objectives change for an OT/PT student from year to year, but the frequency & duration of service does NOT change, is a "new" prescription required?

No. A new prescription is not required.