OT/PT Physician Prescriptions

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SHARS POLICY – Effective November 1, 2021

A prescription is required for OT/PT services. The prescription must be updated a minimum of one time every three (3) calendar years.  The  prescription for OT/PT services must be signed and dated before the initiation of services.

  1. OT services may be reimbursed up to (but not to exceed) the amount designated in the prescription.
  2. A physician’s prescription is not required for a re-evaluation.
  3. The need for a re-evaluation should be determined by the student’s ARD committee.
  4. The LEA must maintain the prescription in the client’s record.

 

In order for a district to receive OT/PT reimbursement through SHARS, written order for services must include:

• Medicaid referring Physician’s printed name

• Physician signature and date must be on the prescription

• Address of the physician must be on the Physician Prescription

• Service being prescribed

• NPI Number

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.

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.

How often must a referral/prescription for physical therapy/occupational therapy or 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.

 

For more information on OT and PT Prescriptions for SHARS reimbursements, please contact your ONWARD Client Services Manager.