Idaho Admin. Code r. 16.03.09.733, Therapy Services: Procedural Requirements

Permits Medicaid reimbursement for therapy services when ordered by a physician, nurse practitioner or physician assistant. Requires the ordering provider to identify the service, frequency, and duration in the therapy order or write an order to ‘evaluate and treat.’ Requires therapists that receive the latter order to create a plan of care based on their evaluation and submit this plan to the ordering provider for approval. Requires providers to periodically reorder services that are necessary for extended periods of time and specifies when such reorders must occur: once every 365 days for long-term medical conditions, once every 60 days for therapy provided by home health agencies, and once every 90 days for all other services. Requires all therapy services to proceed in accordance with a plan of care and specifies the information that must be included in this plan (e.g., diagnoses, treatment goals, type of services etc.).