(a) The department
will pay for only the physical therapy, occupational therapy, and
speech-language pathology services and supplies identified in the Fee
Schedule for Therapy Services, adopted by reference in
7
AAC 160.900, if those services and supplies, except
the initial evaluation, are
(1) prescribed by
a physician, an advanced practice registered nurse, or a physician assistant
who may prescribe those services and supplies within the scope of the
practitioner's license;
(2)
delivered by a physical therapist, an occupational therapist, or a
speech-language pathologist who holds an active license to practice issued by
the jurisdiction in which services are provided and who provides direct
services only within the scope of that license; if services are provided in
this state the individual must hold an active license under AS 08;
and
(3) provided in accordance with
the initial evaluation and treatment plan developed under
7
AAC 115.220.
(b) The department will pay for the services
of an occupational therapy assistant, physical therapy assistant, or
speech-language pathologist assistant if those services are
(1) provided by an assistant who holds an
active license to practice in the jurisdiction in which services are provided;
if the services are provided in this state the individual must hold an active
license under AS 08.84 or AS 08.11, whichever applies;
(2) performed in accordance with the
requirements of
AS
08.11.042,
12 AAC 54.510,
12 AAC 54.810, or
12 AAC 54.820, whichever applies,
or the equivalent requirements in the jurisdiction in which services are
provided; and
(3) billed through
the supervising therapist who meets the requirements of (a)(2) of this
section.
(c) The
department will not pay for the services provided by a occupational therapy
aide, physical therapy aide, or a speech-language pathologist aide.
(d) For an individual 21 years of age or
older, the department will pay for
(1) two
units of physical and occupational therapy evaluation services combined each
state fiscal year;
(2) 30 combined
units of physical and occupational therapy services combined each state fiscal
year;
(3) additional units of
physical and occupational therapy services if the department gives prior
authorization based on medical justification submitted by the
provider;
(4) eight units of
speech-language therapy evaluation services each state fiscal year;
(5) 15 units of speech-language therapy
services each state fiscal year; and
(6) additional units of speech-language
therapy services if the department gives prior authorization based on medical
justification submitted by the provider.
