Current through Register Vol. 54, No. 49, December 7, 2024
Section 1249.56 - Payment conditions for physical therapy, occupational therapy, speech pathology and audiology servicesHome health agencies are reimbursed for physical therapy, occupational therapy, speech therapy and audiology services if the following conditions are met:
(1) The service is prescribed by the recipient's attending physician.(2) The service is performed by a physical therapist, occupational therapist, speech therapist or audiologist currently licensed to practice in this Commonwealth.(3) The service is reasonable and necessary for the treatment of the recipient's illness or injury. To be considered reasonable and necessary, the services furnished shall be: (i) Consistent with the recipient's particular medical needs as ordered by the recipient's attending physician.(ii) Consistent with accepted standards of medical practice.The provisions of this § 1249.56 adopted December 6, 1980, effective 12/1/1980, 10 Pa.B. 4618; amended December 23, 1983, effective 1/1/1983, 13 Pa.B. 3932; amended August 12, 1988, effective 9/1/1988, 18 Pa.B. 3571; amended September 30, 1988, effective 10/1/1988, 18 Pa.B. 4418.The provisions of this § 1249.56 amended under sections 403(a) and (b), 443.2(2) and 509 of the Public Welfare Code (62 P. S. §§ 403(a) and (b), 443.2(2) and 509).
This section cited in 55 Pa. Code § 1249.51 (relating to general payment policy).