Section 260.355 - Therapies(a) A program provider must provide or ensure the provision of the following therapies: (1) occupational therapy;(3) speech-language pathology;(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:(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.26 Tex. Admin. Code § 260.355
Adopted by Texas Register, Volume 48, Number 07, February 17, 2023, TexReg 0915, eff. 2/26/2023