Or. Admin. Code § 410-129-0060

Current through Register Vol. 64, No. 1, January 1, 2025

Section 410-129-0060 - Prescription Required

(1) The prescription is the written order by the prescribing practitioner pursuant to state law governing SLP, audiology, and hearing aid services. Prescription shall specify the ICD diagnosis code for all SLP, audiology, and hearing aid services that require payment/prior authorization.

(2) The provision of speech therapy services shall be supported by a written order and a therapy treatment plan signed by the prescribing practitioner. A practitioner means an individual licensed pursuant to state law to engage in the provision of health care services within the scope of the practitioner's license or certification.

(3) A written order:

(a) Is required for the initial evaluation;

(b) For therapy, shall specify the ICD diagnosis code, service, amount, and duration required.

(4) Written orders shall be submitted with claims that are subject to PPR or that require PA request, and a copy shall be on file in the provider's therapy record. The written order and the treatment plan shall be reviewed and signed by the prescribing practitioner every six months.

(5) Authorization of payment to an audiologist or hearing aid dealer for a hearing aid will be considered only after examination for ear pathology and written prescription for a hearing aid by an ear, nose, and throat specialist (ENT) or general practitioner who has training to examine the ear and performs within the scope of his practice, i.e., primary care physician (not appropriate for an orthopedic specialist, chiropractor, gynecologist, etc.).

Or. Admin. Code § 410-129-0060

AFS 67-1985, f. 11-19-85, ef. 12-1-85; HR 5-1991, f. 1-18-91, cert. ef. 2-1-91, Renumbered from 461-021-0301; HR 27-1993, f. & cert. ef. 10-1-93; HR 36-1994, f. 12-30-94, cert. ef. 1-1-95; OMAP 36-1999, f. & cert. ef. 10-1-99; DMAP 6-2007, f. 6-14-07, cert. ef. 7-1-07; DMAP 51-2015, f. 9-22-15, cert. ef. 10/1/2015; DMAP 49-2016, f. 7-26-16, cert. ef. 8/1/2016; DMAP 56-2017, amend filed 12/26/2017, effective 1/1/2018; DMAP 18-2019, temporary amend filed 06/18/2019, effective 7/1/2019 through 12/27/2019; DMAP 44-2019, amend filed 11/06/2019, effective 11/14/2019

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: ORS 414.025 & ORS 414.065