SECTION 260.355. Therapies

(a) A program provider must provide or ensure the provision of the following therapies:

(1) occupational therapy;

(2) physical therapy;

(3) speech-language pathology;

(4) audiology; and

(5) dietary services.

(b) A program provider must ensure a therapy:

(1) is delivered by an appropriately licensed service provider, as follows:

(A) for occupational therapy, an occupational therapist licensed in accordance with Texas Occupations Code Chapter 454;

(B) for physical therapy, a physical therapist licensed in accordance with Texas Occupations Code Chapter 453;

(C) for speech-language pathology, a speech-language pathologist licensed in accordance with Texas Occupations Code Chapter 401;

(D) for audiology, an audiologist licensed in accordance with Texas Occupations Code Chapter 401; or

(E) for dietary services, a dietitian licensed in accordance with Texas Occupations Code Chapter 701.

(2) includes, as appropriate, the following activities:

(A) screening and assessment;

(B) developing and implementing a treatment plan that, as appropriate, includes a plan to:

(i) transfer a therapy task to an unlicensed service provider; and

(ii) change the role of the therapist to a supervisory role;

(C) directing therapeutic intervention in accordance with the appropriate chapter of the Texas Occupations Code;

(D) consulting with or training of family members and other service providers;

(E) participating on an individual's service planning team, when appropriate;

(F) informing the physician and other appropriate professionals of changes in the individual's health status that may require a change in the IPC;

(G) preparing a report to the case manager as described in subsection (g) of this section;

(H) supervising and training an unlicensed service provider within the scope of applicable state statutes and rules; and

(I) conducting assessments and preparing specifications for the procurement of an adaptive aid or minor home modification; and

(3) is provided to an individual at a location agreeable to the individual or LAR.

(c) A program provider must:

(1) obtain a physician's order for therapy before the delivery of the therapy;

(2) ensure that the physician's order includes the following:

(A) individual's name;

(B) type of therapy;

(C) frequency and duration of therapy;

(D) other instructions, if applicable;

(E) physician's name and medical specialty; and

(F) effective date of the order; and

(3) retain the physician's order in the individual's record.

(d) A program provider may accept faxed physician's orders for therapy services.

(1) The program provider does not have to obtain a countersignature of the faxed orders by the prescribing physician.

(2) The program provider must ensure the faxed orders are legible.

(e) If requested by an individual's service planning team, a service provider of a therapy may screen an individual for therapy services without obtaining a physician's order.

(f) A program provider may bill HHSC only for the following therapy activities:

(1) screening, assessing, and evaluating the need for services;

(2) developing and implementing a treatment plan;

(3) periodically evaluating the individual's progress toward achieving the goals and outcomes described in the IPP for the therapy service and providing updates to the program provider;

(4) providing direct therapeutic intervention;

(5) interacting with the individual or LAR regarding the individual's condition and progress toward or achievement of goals;

(6) training the individual to use an adaptive aid;

(7) delegating therapy tasks to an unlicensed person in accordance with rules of the appropriate licensing board;

(8) consulting with family members and other service providers regarding the individual's DBMD Program and CFC services;

(9) informing the physician and the program provider of changes in the individual's health status requiring a service plan change;

(10) participating in service planning team meetings, if requested;

(11) supervising and training an unlicensed service provider within the scope of the therapy examining board rules;

(12) participating in a fair hearing at the request of a member of the service planning team to provide information within the scope of the service provider's license;

(13) assisting with writing specifications for adaptive aids; and

(14) providing consultation or justification for the procurement of an adaptive aid or minor home modification.

(g) A program provider must ensure an appropriately licensed therapist provides a report to the individual's case manager at least 10 calendar days before the review described in §260.77(a) of this chapter (relating to Renewal and Revision of an IPP and IPC) that:

(1) reviews the individual's progress toward achieving the goals and outcomes described in the IPP for that therapy;

(2) reviews whether the services are meeting the individual's needs;

(3) documents whether the individual's needs have changed; and

(4) documents attempts to teach maintenance services and techniques to other service providers.

Source Note: The provisions of this §260.355 adopted to be effective February 26, 2023, 48 TexReg 896