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Doctor's RX for School Therapy
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Doctor's RX for School Therapy - July 27, 2000 6:33:00 PM
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JFR
Posts: 1
Joined: July 26, 2000
From: NJ
Status: offline
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This is first post so bear with me and please excuse any e post bloopers I may make. That said, I would appreciate any information on the best process for aquiring proper authorization for provision of physical therapy in the educational setting. Is it different by state ? If so, specific regs or where I might go to access those pertaining to NJ are needed.It is my understanding that a PT assessment may be done for the IEP without a Dr.'s RX, is that true? Who's responsible to aquire the RX for PT school treatments, the school or the therapist? How specific do the RX's have to be ( ie. to including exact frequencies and durations of tx , identifying specific treatment modalities and stratagies ) ? How often should they be renewed, monthly, quaterly or yearly ?
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Re: Doctor's RX for School Therapy - July 28, 2000 12:39:00 AM
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Andrew M. Ball, MS, PT
Posts: 500
Joined: October 8, 1999
From: Chapel Hill, NC, USA
Status: offline
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Excellent question JFR welcome to the forum,
I hate to give this kind of answer, because it always pisses me off when people say this to me . . . you'll have to check with you state board of physical therapy examiners for specifics in your state.
That said, when I practiced for United Cerebral Palsy and BOCES when in New York, this was the drill:
In the direct access state, MD's order was not required to treat, but if anything (e.g. orthotics, equipment, etc. was going to be billed to insurance or medicaid, then the whole sha-bang had to be docummented and authorized by an MD). That meant that in truth, authorization was required for everything, but not for legal reasons . . . rather for reimbursement reasons. Authorization requests were filled out by the evaluating therapist and forwarded by the director of rehab to the medical director for authorization.
Standard practice there therefore, was that examination and evaluation could be preformed by a PT prior to that authroization because the IFSP (e.g. part C) needs to be written 45 days from referral and the IEP (part B) within 90 days. After the eval is completed, then authorization was requested prior to Rx starting, and they lasted for 6 months upon which time they needed to be renewed, with new goals. If you didn't reach your goals, then IEP's were often accompanied by a note that let you know that goals must be accomplished next time, or don't expect re-authorization. That helped to keep goals functional and prevented kids getting PT on the basis of Dx alone, to keep PT that didn't help, for years and years and years.
As far as units are concerned, that's tricky. In North Carolina, for example, PT's being paid through Medicaid have the option to write frequency in terms of units (e.g. instead of twice a week, 52 units per 6 months). That allows a little flexability if the kid is doing particularly well one week, and crappy the next, but in truth, no PT has that kind of flexabilty in their schedule, so very few PT's actually write goals and treat that way . . . but they could if they wanted to. I'm not sure how NJ works, you'll have to ask your supervisor.
Drew
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Re: Doctor's RX for School Therapy - July 28, 2000 4:00:00 AM
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Dana D
Posts: 142
Joined: September 18, 1999
Status: offline
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Try contacting the school district in which you are talking about... contact their special education department and ask to speak with someone about the regulations.
I know that in order to be eligible for school based services, the child has to have needs which directly affect them educationally... ie(their mobility from class to class, their ability to go up and down stairs, to carry an object across the room, to negotiate obstacles/toys in their way... even their play skills such as ball catching/kicking/throwing because that will affect their participation with peers in gym and free play..etc..)
School based services won't be applicable for a child who fractured their arm say.. because by the time the evaluation is completed and the meeting is set and what not, the child will be recovered from the fracture and that's that....
You def. need a script to treat (in NY atleast)... I know from where I work, they didn't have to be very specific... but yet again it's district specific i'm sure. It was the PT's responsibility to get the script.. Typically the parents would submit them to the teachers or special ed. dept. , but we had to make sure we got a copy of it prior to beginning services. If some parents were slacking, we had to help hunt the script down.
I hope I've helped you in some way! Good luck and ask anything else [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]
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