Therapy referral intake and follow-up

Occupational, physical and speech therapy practices serving children, adults or both should treat a referral as a request, not a booking: log it the day it arrives, give it one owner, send clinical questions to a clinician, reach the patient or parent by a permitted route, verify orders and coverage, and track it to a recorded close.

This guide covers referrals sent by professionals and referrals that families and adults make for themselves. How to answer a first call, write a first email or run the waitlist is in the intake guides it links to; what follows is the workflow that carries each referral from arrival to a close.

What should happen when a therapy referral first arrives?

Log it, give it an owner, read it for the question it asks, and track it to a recorded close; receiving a referral does not mean the practice has accepted the patient. A referral raises questions only the practice can answer: whether the service fits, whether a clinician with the right skills has room, whether the payer’s conditions are met, and whether the person wants to come.

1. Receive. Log it in the record system the day someone sees it, with its source, channel and time of arrival.
2. Assign. Name one owner and one backup, who keep it until it closes.
3. Route. Clinical questions go to the routing clinician, payer questions to whoever verifies benefits.
4. Contact. Reach the adult, or a child’s parent or guardian, by a permitted route the person prefers.
5. Verify. Check the order a payer requires, eligibility, authorization and clinician time.
6. Close. Record the outcome and tell the referrer what the rules permit.

Is there a required response time for therapy referrals?

The first-response target is the practice’s own, set from its staffing, and the clinical situation sets urgency case by case. A practice may aim to reach every new referral before the close of the next business day if the staff can meet that in their busiest week; urgent information follows a clinician-approved route outside the target. Write it down as a target, not as a rule.

Some clocks are set elsewhere. When a self-pay or uninsured person books, the No Surprises Act rule sets the good faith estimate’s deadline by lead time: 1 business day after booking a visit at least 3 business days out, 3 business days after booking one at least 10 business days out, and 3 business days after a request; talking about cost counts as a request.⁠¹ Medicare certification and authorization dates are in the orders and referrals guide, and reply targets for each inquiry channel in the reply standards guide.

Where do therapy referrals come from, and how do they arrive?

From professionals who send a patient and from people who refer themselves or their child. Professionals include pediatricians and family physicians, hospital and rehabilitation teams at discharge, specialists, other therapists, and school or early intervention staff; the rest are parents, adult patients, caregivers and families writing through a directory. They arrive by fax and e-fax, electronic referral through a health record or referral portal, phone, email, the website form and directory inquiries, and each channel needs an owner who checks it on a schedule. Building those relationships is the subject of the adult referrals guide and the pediatrician referrals guide; this page starts when a referral lands.

How does a DrSensory inquiry enter the referral workflow?

As a family referral. On a paid listing, the message is held in the clinic’s portal, a notice goes to the clinic’s inquiry address, and the clinic replies from its own email; on a listing without a paid plan, the message goes to the DrSensory team, which tries to reach the clinic by forwarding it on the family’s behalf and cannot promise that the clinic receives or answers it.⁠^12,13 Give the notice address an owner, and log each message in the record system so it moves through the same statuses as a physician’s referral.⁠¹⁴ A directory message settles nothing about fit, coverage or urgency. DrSensory lists clinics, not individual therapists; it neither vouches for clinical quality nor sells leads.⁠^12,13,14

Who should own a therapy referral from the moment it arrives?

One named person per channel, with a named backup, owns each referral until it closes: checking the channel, logging, confirming receipt, contacting the patient, chasing missing items, routing clinical questions and recording each status. A solo practitioner holds every role and a larger clinic splits them, but each role has a name.

Access follows the map: a covered practice must identify which staff need which categories of patient information for their duties, and limit their access to match.⁠^6,15 HIPAA applies if the practice is a covered entity, and for a provider that turns on whether it sends health information electronically in connection with a transaction covered by an HHS standard.⁠¹⁶

How do you cover referrals during absences and weekends?

Write the coverage before it is needed. The queue is shared, so no referral waits in the inbox of someone on leave, and the backup works it from the first day of the absence. On closed days, the voicemail greeting and email auto-reply say when messages are next read and what to do about anything urgent, and confirm receipt without promising an appointment. A discharge referral can arrive on a Friday evening, so decide whether anyone reads the e-referral queue at weekends, and tell referring hospitals the answer.

How should front-desk staff route a referral’s clinical questions?

Staff sort referrals by discipline, age group and missing items, and pass anything clinical to a clinician on a route the clinicians wrote; they do not triage, diagnose or judge fit from a script. Whether a request is within the practice’s skills, a named discipline that may not match the concern, records that conflict, a service the practice does not offer and anything time-sensitive all go to the routing clinician, whose answer is recorded as a short routing note. Redirecting a referral is a clinical judgment the codes expect: ASHA’s tells SLPs to use every resource, referral included, to ensure quality service, and APTA’s tells PTs to refer to another health care professional when referral serves the patient’s best interests.⁠^17,18

What should intake do when a referral suggests something urgent?

Follow the clinician-approved escalation route at once; urgent information never waits for a routine callback. The route names the clinician to reach, a second person when that clinician is unavailable, what staff say to a caller describing a sudden change (to contact their physician, or emergency services in an emergency), and how the escalation is recorded. Staff do not judge safe delays, interpret discharge instructions or promise an "urgent slot". If the practice cannot meet the timing, the patient and the referrer hear that the same day.

Must intake staff accept relay calls and arrange interpreters?

Yes. Under the ADA, a business serving the public must make its communication with people who have hearing, vision or speech disabilities as effective as with anyone else, accept TRS and VRS relay calls and handle them as it would any call; the duty reaches a patient’s parent, spouse or companion where appropriate, and staff may not insist that someone bring their own interpreter.⁠¹¹ Record the need in the referral so the contact and the visit are arranged around it; the accessible inquiry forms guide covers written routes. An adult referred for speech-language therapy after a stroke may need more time or written choices, and the conversation is still with them.

What status should each therapy referral carry until it closes?

One status at a time, from a fixed list in which each status has a test for entering it, so anyone can see where every referral stands and nothing looks finished before it is. The owner changes the status, the weekly review reads it and the referral log reports it.

When can a referral be marked scheduled, declined or closed?

Scheduled when the person has confirmed a specific appointment; declined when the person said no; not accepted when a clinician recorded why; closed for no contact when the attempts rule has run and a closing message has gone. A form emailed to a parent is not scheduled, an unreturned voicemail is not declined, and a waitlist place is not an appointment. Accurate statuses keep reports honest and protect the person: a referral marked declined because a family missed a call can stop anyone from trying again.

What does a therapy referral need before anyone calls the patient?

Enough to reach the right person and route the request, kept in the record system rather than on a marketing sheet:

• Patient: name, date of birth and the state where they live.
• Who to contact: the adult; for a child, a parent or guardian; any personal representative, with the document giving the authority.
• Contact route: phone, email or portal, any stated preference, and any request for confidential communication.
• Referrer: name, credentials, practice, NPI and a secure route back.
• The question: the discipline (PT, OT or SLP), what the referrer wants assessed, and the reason as written.
• Payer: the plan and any order or authorization it requires.
• Access needs and urgency: an interpreter, relay calls or visit needs; an urgency flag set by the referrer or a clinician, never guessed by staff.

Does the minimum necessary rule limit what a referral can contain?

Not for the referral itself: treatment disclosures to a provider, and a provider’s requests for treatment, sit outside the rule, so a referrer may send what the treating therapist needs and the practice may ask for more.⁠^5,19 It does govern other uses: payment and operations disclosures are limited to the minimum necessary, and staff access is limited by role.⁠^6,15 So the report marketing reads on referral sources carries totals, never names.

What if the referral names the wrong discipline or population?

A clinician clarifies the route with the referrer or the family before anyone books; staff do not turn a PT referral into an OT one, or send an adult to a pediatric clinician, on their own judgment. A referral for "therapy" with no discipline, or one for a service or age group the practice does not serve, goes to clinical review, and the clinician confirms a route or closes it as redirected with accurate options.

How should a practice first contact a referred patient or family?

Reach the person who decides, by a route the practice may use and the person prefers, say only what that route can safely carry, and confirm who you are speaking with before discussing details. The first contact says a referral arrived and what happens next; it does not promise an appointment, coverage or a result.

Which family members can intake staff talk to about a referral?

For a child, the personal representative is in most cases a parent, guardian or someone acting in loco parentis; the exceptions track state laws that let minors consent to certain care, and a grandparent or sitter who picks up the phone does not become one by answering.⁠^5,7 A court can give that authority to someone other than a parent, so when it is in question, ask and keep the document.⁠⁷

For an adult, contact the adult. An agent under a health care power of attorney, or a guardian a court appointed, acts as the adult’s personal representative within the scope of that authority.⁠^5,7 A relative who drives the adult to visits may hear what bears directly on that help if the adult agrees, or raises no objection when asked.⁠^20,21

What may a first voicemail, email or text say about a referral?

As little as the route can safely carry. HHS does not bar messages on an answering machine, but it advises keeping them sparse: only the practice’s name and phone number, or a request to return the call.⁠⁹ Email with patients is allowed with reasonable safeguards, such as confirming the address before sending and limiting what goes in an unencrypted message; a patient who writes first by email can be answered by email unless they have said otherwise, and the practice may point out the risks and leave the choice to them.⁠⁸ HHS frames that answer as communicating electronically, with email as its example, so apply the same restraint to a text; consent rules for automated texts are in the reply standards guide.

If a patient asks to be contacted another way or at another place, a covered provider has to accommodate a reasonable request and may not ask the reason.⁠¹⁰ Leave the referrer’s diagnosis out of a first message; the person may share a phone or inbox.

The intake call script and the new patient email templates carry the conversation from there.

What should be verified before a referred patient’s first visit?

Four things, each recorded as verified or still unknown: the order or referral a payer or state requires, eligibility and any prior authorization, the practice’s network status, and clinician time for both the evaluation and the care that may follow. The orders and referrals guide sets out which document each payer and discipline needs.

• Coverage. Preauthorization means the plan has judged the service medically necessary; it is not a promise to pay, so record what was approved, for which dates and visits.⁠²² For children on Medicaid, see the EPSDT guide; the Medicaid enrollment guide and the TRICARE participation guide cover those programs.
• Network status. Do not book a visit as in-network while credentialing is pending; see the credentialing guide and, for patients outside your networks, the out-of-network benefits guide.
• Self-pay cost. Let an uninsured or self-pay person know they can get a good faith estimate, and send it within the rule’s timeframes once they book.⁠¹

Should a practice book the evaluation before treatment capacity exists?

Only when the person knows that is what they are getting: an evaluation slot next week does not mean a weekly treatment slot after it. Say both parts plainly, record the treatment wait in the referral, and offer the waitlist for treatment as a separate choice with no promised start date. Some families would rather start sooner elsewhere, and they can only choose if they know.

What should the referring clinician hear back, and when?

Tell the referrer the referral arrived, then what became of it, through a secure route, as part of coordinating care. HIPAA’s definition of treatment covers sending a patient on to another provider, and a covered provider may disclose information both for its own treatment and for another provider’s treatment activities, even a provider HIPAA does not reach; consent is optional.⁠^2,3,15 Providers may exchange it electronically for treatment with reasonable safeguards.⁠²³

The permission is for providers. A teacher, coach or employer who suggested therapy is not treating the patient, and an update to them usually needs a written authorization from the adult or the parent.⁠⁴ A restriction the practice agreed to binds it, though a provider is not required to agree to most such requests.⁠^5,10 The professions add their own duty: APTA’s code bars disclosure of confidential information without the patient’s authorization unless the law allows or requires it, and ASHA’s allows disclosure only when legally authorized or required.⁠^17,18

What should a referral acknowledgment to the referrer say?

That the referral arrived, who owns it, what happens next and what is missing, and nothing that reads as acceptance.

When does a referrer get an outcome note, and what does it contain?

When the referral closes or a first appointment is confirmed: a short administrative note with the outcome and the next document to expect. The evaluation report and plan of care follow as their own documents.

Keep both notes free of requests for more referrals and of promotional material. The end of care closes its own loop; the discharge guide covers what the referring practitioner receives then.

How do pediatric and adult referrals differ in practice?

In who decides, who else is involved and which systems sit beside the clinic: a child’s referral runs through a parent, often alongside school or early intervention services, and an adult’s runs through the adult, with any caregiver in the role the adult sets.

How do you handle a pediatrician’s referral when a parent must call?

Contact the parent yourself when the referral gives a way to reach them, rather than waiting for the call the pediatric office suggested, and keep the referral in Contacting until a parent answers. Contacting the family to arrange care is part of the practice’s own treatment and operations, which HIPAA permits.⁠³ If there is no working number, ask the referring office for one rather than closing the referral. When separated parents both call, each is in most cases a personal representative, but a court can give that authority to someone else; ask when it matters.⁠⁷

What does a hospital discharge referral for an adult need from intake?

A quick clinical read, the adult’s own decision, a caregiver role the adult sets, and the hospital’s records. Medicare’s hospital conditions of participation require discharge planning that includes the patient and caregivers or support persons as active partners and, where the hospital transfers or refers the patient, require it to send the necessary medical information to the outpatient providers responsible for follow-up care.⁠²⁴ If the records are missing, ask the discharge team; the clinician, not the front desk, reads the discharge instructions. With the adult’s agreement, a relative may hear what their part needs, as in HHS’s example of telling a sister about mobility limits before she drives the patient home.⁠²¹ The adult referrals guide covers building the discharge pathway.

Where do school and early intervention referrals belong?

In their own systems, run alongside any clinic care. Under IDEA, a parent or the school system can ask for a child’s initial evaluation, and Part C counts physicians, hospitals and other health care providers and clinics among its primary referral sources, whose state procedures must have a child under three referred as soon as possible and within seven days of being identified.⁠^25,26 Learn your state’s Part C intake route before a case needs it, and for coordination with a school, see the IEP teams guide.

Which referral sources need which checks, and who acts on each?

Match the source to the checks it raises; the table is a starting map for the intake policy, not a substitute for the payer’s manual or the practice’s counsel.

What should a referral log record so every referral is resolved?

One line per referral in the record system, with its source, dates, status, owner and outcome, reviewed weekly until every line has a closing status. A referral missing from the log was never handled.

Measure from the log in aggregate, without names: time from receipt to first attempt, to two-way contact, to an offer and to a scheduled visit, and the share closing under each status, by source and discipline. Define business hours and each clock’s starting event first, and judge each month against the practice’s own past months rather than an outside number. A low scheduled share can reflect capacity, payment, transport, mismatch, contact problems or the person’s choice; reading those cases is covered in why callers do not book.

What does the workflow look like for one child and one adult?

Each case moves through the statuses above in order. Both are invented, and their dates and plan details exist only for the example.

How do you test a referral workflow before relying on it?

Write the workflow on one sheet, push a fictional referral through it on a day the primary owner is out, and fix every place it stalls.

Run the test again after any change in staff, systems or channels, including a new directory listing or referral portal.

Sources

1. Code of Federal Regulations. 45 CFR 149.610, Requirements for provision of good faith estimates of expected charges for uninsured (or self-pay) individuals (eCFR, Title 45 up to date as of October 23, 2026). Checked October 26, 2026.
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   “Informing all uninsured (or self-pay) individuals of the availability of a good faith estimate of expected charges upon scheduling an item or service or upon request”; “Convening providers and convening facilities shall consider any discussion or inquiry regarding the potential costs of items or services under consideration as a request for a good faith estimate”; “When a primary item or service is scheduled at least 3 business days before the date the item or service is scheduled to be furnished: Not later than 1 business day after the date of scheduling”; “When a primary item or service is scheduled at least 10 business days before such item or service is scheduled to be furnished: Not later than 3 business days after the date of scheduling”; “When a good faith estimate is requested by an uninsured (or self-pay) individual: Not later than 3 business days after the date of the request.”.
2. Code of Federal Regulations. 45 CFR 164.501, Definitions (eCFR, Title 45 up to date as of October 23, 2026; HIPAA Privacy Rule, the definition of treatment). Checked October 26, 2026.
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   “Treatment means the provision, coordination, or management of health care and related services by one or more health care providers, including the coordination or management of health care by a health care provider with a third party; consultation between health care providers relating to a patient; or the referral of a patient for health care from one health care provider to another.”.
3. Code of Federal Regulations. 45 CFR 164.506, Uses and disclosures to carry out treatment, payment, or health care operations (eCFR, Title 45 up to date as of October 23, 2026; HIPAA Privacy Rule). Checked October 26, 2026.
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   “A covered entity may obtain consent of the individual to use or disclose protected health information to carry out treatment, payment, or health care operations.”; “A covered entity may use or disclose protected health information for its own treatment, payment, or health care operations.”; “A covered entity may disclose protected health information for treatment activities of a health care provider.”.
4. Code of Federal Regulations. 45 CFR 164.508, Uses and disclosures for which an authorization is required (eCFR, Title 45 up to date as of October 23, 2026; HIPAA Privacy Rule, paragraph (a)(1)). Checked October 26, 2026.
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   “Except as otherwise permitted or required by this subchapter, a covered entity may not use or disclose protected health information without an authorization that is valid under this section.”.
5. Code of Federal Regulations. 45 CFR 164.502, Uses and disclosures of protected health information: General rules (eCFR, Title 45 up to date as of October 23, 2026; HIPAA Privacy Rule, paragraphs (b), (c) and (g)). Checked October 26, 2026.
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   “When using or disclosing protected health information or when requesting protected health information from another covered entity or business associate, a covered entity or business associate must make reasonable efforts to limit protected health information to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request.”; “This requirement does not apply to:”; “Disclosures to or requests by a health care provider for treatment”; “A covered entity that has agreed to a restriction pursuant to § 164.522(a)(1) may not use or disclose the protected health information covered by the restriction in violation of such restriction”; “If under applicable law a person has authority to act on behalf of an individual who is an adult or an emancipated minor in making decisions related to health care, a covered entity must treat such person as a personal representative under this subchapter, with respect to protected health information relevant to such personal representation.”; “If under applicable law a parent, guardian, or other person acting in loco parentis has authority to act on behalf of an individual who is an unemancipated minor in making decisions related to health care, a covered entity must treat such person as a personal representative under this subchapter”.
6. Code of Federal Regulations. 45 CFR 164.514, Other requirements relating to uses and disclosures of protected health information (eCFR, Title 45 up to date as of October 23, 2026; HIPAA Privacy Rule, paragraph (d)(2), minimum necessary uses). Checked October 26, 2026.
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   “Those persons or classes of persons, as appropriate, in its workforce who need access to protected health information to carry out their duties”; “For each such person or class of persons, the category or categories of protected health information to which access is needed and any conditions appropriate to such access.”; “A covered entity must make reasonable efforts to limit the access of such persons or classes”.
7. U.S. Department of Health and Human Services, Office for Civil Rights. Personal Representatives (HIPAA Privacy Rule guidance; content last reviewed January 5, 2024). Checked October 26, 2026.
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   “In most cases under the Rule, a parent, guardian, or other person acting in loco parentis (collectively, “parent”) is the personal representative of the minor child”; “These exceptions generally track the ability of certain minors to obtain specified health care without parental consent under State or other laws, or standards of professional practice.”; “A court may grant authority to make health care decisions for the minor to an adult other than the parent”; “A person with legal authority to make health care decisions on behalf of the individual”; “Health care power of attorney”; “Court appointed legal guardian”.
8. U.S. Department of Health and Human Services, Office for Civil Rights. Does the HIPAA Privacy Rule permit health care providers to use e-mail to discuss health issues and treatment with their patients? (HIPAA FAQ, created December 15, 2008; content last reviewed July 26, 2013). Checked October 26, 2026.
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   “The Privacy Rule allows covered health care providers to communicate electronically, such as through e-mail, with their patients, provided they apply reasonable safeguards when doing so.”; “checking the e-mail address for accuracy before sending, or sending an e-mail alert to the patient for address confirmation prior to sending the message”; “other safeguards should be applied to reasonably protect privacy, such as limiting the amount or type of information disclosed through the unencrypted e-mail”; “Patients may initiate communications with a provider using e-mail. If this situation occurs, the health care provider can assume (unless the patient has explicitly stated otherwise) that e-mail communications are acceptable to the individual.”; “the provider can alert the patient of those risks, and let the patient decide whether to continue e-mail communications”.
9. U.S. Department of Health and Human Services, Office for Civil Rights. May physician’s offices or pharmacists leave messages for patients at their homes? (HIPAA FAQ, created December 19, 2002; content last reviewed December 28, 2022). Checked October 26, 2026.
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   “the Rule does not prohibit covered entities from leaving messages for patients on their answering machines.”; “covered entities should take care to limit the amount of information disclosed on the answering machine.”; “a covered entity might want to consider leaving only its name and number and other information necessary to confirm an appointment, or ask the individual to call back.”.
10. Code of Federal Regulations. 45 CFR 164.522, Rights to request privacy protection for protected health information (eCFR, Title 45 up to date as of October 23, 2026; HIPAA Privacy Rule, paragraphs (a) and (b)). Checked October 26, 2026.
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    “a covered entity is not required to agree to a restriction.”; “A covered health care provider must permit individuals to request and must accommodate reasonable requests by individuals to receive communications of protected health information from the covered health care provider by alternative means or at alternative locations.”; “A covered health care provider may not require an explanation from the individual as to the basis for the request as a condition of providing communications on a confidential basis.”.
11. U.S. Department of Justice, Civil Rights Division, ADA.gov. ADA Requirements: Effective Communication (last updated February 28, 2020). Checked October 26, 2026.
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    “title III entities (businesses and nonprofit organizations that serve the public) communicate effectively with people who have communication disabilities”; “The rules apply to communicating with the person who is receiving the covered entity’s goods or services as well as with that person’s parent, spouse, or companion in appropriate circumstances.”; “Covered entities are also required to accept telephone calls placed through TRS and VRS, and staff who answer the telephone must treat relay calls just like other calls.”; “They cannot require a person to bring someone to interpret for him or her.”.
12. DrSensory. DrSensory for therapists (the For Therapists hub). Checked October 26, 2026.
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    “Families search it for occupational, physical and speech therapy near them, read profiles and send messages.”; “The directory lists clinics rather than individual therapists, so one listing covers a whole practice at one address.”; “The message itself is read in the portal, not sent by email, because what a parent writes about their child is health information. You reply from your own address.”; “On a paid listing, your team does, in the portal; the email you receive only says a message is waiting.”; “On a listing without a paid plan, the message comes to the DrSensory team, who try to reach the clinic by forwarding it on the family’s behalf; DrSensory cannot guarantee that the clinic receives or answers it.”; “DrSensory does not verify clinical quality, and says so on every results page.”.
13. DrSensory. Therapy Clinic Directory Pricing (the pricing page). Checked October 26, 2026.
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    “When a family writes from your profile, the address you gave for family inquiries is told that a message is waiting; you read it signed in, because what a parent writes about their child is health information, and you reply from your own address.”; “We do not verify clinical quality.”; “We do not sell your leads.”.
14. DrSensory. How to claim and optimize your DrSensory profile (a For Therapists guide). Checked October 26, 2026.
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    “The address you give for family inquiries is not shown on your profile; it is where DrSensory tells you a message is waiting, so make it a practice address someone checks.”; “A directory inquiry does not establish suitability, coverage, urgency, or a treatment plan.”.
15. U.S. Department of Health and Human Services, Office for Civil Rights. Uses and Disclosures for Treatment, Payment, and Health Care Operations (HIPAA Privacy Rule guidance; content last reviewed July 26, 2013). Checked October 26, 2026.
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    ““Treatment” generally means the provision, coordination, or management of health care and related services among health care providers or by a health care provider with a third party, consultation between health care providers regarding a patient, or the referral of a patient from one health care provider to another.”; “A covered entity may disclose protected health information for the treatment activities of any health care provider (including providers not covered by the Privacy Rule).”; “A primary care provider may send a copy of an individual’s medical record to a specialist who needs the information to treat the individual.”; “A covered entity must develop policies and procedures that reasonably limit its disclosures of, and requests for, protected health information for payment and health care operations to the minimum necessary.”; “A covered entity also is required to develop role-based access policies and procedures that limit which members of its workforce may have access to protected health information for treatment, payment, and health care operations, based on those who need access to the information to do their jobs.”; “However, covered entities are not required to apply the minimum necessary standard to disclosures to or requests by a health care provider for treatment purposes.”; “A covered entity may voluntarily choose, but is not required, to obtain the individual’s consent for it to use and disclose information about him or her for treatment, payment, and health care operations.”.
16. U.S. Department of Health and Human Services, Office for Civil Rights. Covered Entities and Business Associates (content last reviewed August 21, 2024). Checked October 26, 2026.
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    “If an entity does not meet the definition of a covered entity or business associate, it does not have to comply with the HIPAA Rules.”; “but only if they transmit any information in an electronic form in connection with a transaction for which HHS has adopted a standard.”.
17. American Speech-Language-Hearing Association. Code of Ethics (2023; effective March 1, 2023; Principle of Ethics I, Rules of Ethics). Checked October 26, 2026.
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    “Individuals shall use every resource, including referral and/or interprofessional collaboration when appropriate, to ensure that quality service is provided.”; “Individuals shall protect the confidentiality of information about persons served professionally or participants involved in research and scholarly activities. Disclosure of confidential information shall be allowed only when doing so is legally authorized or required by law.”.
18. American Physical Therapy Association. Code of Ethics for the Physical Therapy Profession (PDF linked from APTA’s policy page, dated January 1, 2026; Standards of Conduct 1.2 and 8.1). Checked October 26, 2026.
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    “Physical therapists and physical therapist assistants shall protect patients’ and clients’ confidential information and not disclose that confidential information except as authorized by the patient or client or as permitted or required by law.”; “Physical therapists shall recognize and practice within the limits of their skills and competence and refer a patient or client to another health care professional when it is in the best interests of the patient or client.”.
19. U.S. Department of Health and Human Services, Office for Civil Rights. Minimum Necessary Requirement (HIPAA Privacy Rule guidance; content last reviewed July 26, 2013). Checked October 26, 2026.
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    “The minimum necessary standard does not apply to the following:”; “Disclosures to or requests by a health care provider for treatment purposes.”; “For uses of protected health information, the covered entity’s policies and procedures must identify the persons or classes of persons within the covered entity who need access to the information to carry out their job duties, the categories or types of protected health information needed, and conditions appropriate to such access.”.
20. Code of Federal Regulations. 45 CFR 164.510, Uses and disclosures requiring an opportunity for the individual to agree or to object (eCFR, Title 45 up to date as of October 23, 2026; HIPAA Privacy Rule, paragraph (b)). Checked October 26, 2026.
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    “disclose to a family member, other relative, or a close personal friend of the individual, or any other person identified by the individual, the protected health information directly relevant to such person’s involvement with the individual’s health care or payment related to the individual’s health care.”; “Obtains the individual’s agreement;”; “Provides the individual with the opportunity to object to the disclosure, and the individual does not express an objection”.
21. U.S. Department of Health and Human Services, Office for Civil Rights. If the patient is present and has the capacity to make health care decisions, when does HIPAA allow a health care provider to discuss the patient’s health information with the patient’s family, friends, or others involved in the patient’s care or payment for care? (HIPAA FAQ, created September 16, 2008; content last reviewed July 26, 2013). Checked October 26, 2026.
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    “a health care provider may discuss the patient’s health information with a family member, friend, or other person if the patient agrees or, when given the opportunity, does not object.”; “the health care provider may share or discuss only the information that the person involved needs to know about the patient’s care or payment for care.”; “A doctor may give information about a patient’s mobility limitations to the patient’s sister who is driving the patient home from the hospital.”.
22. HealthCare.gov, Centers for Medicare & Medicaid Services. Preauthorization (glossary entry). “A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.”; “Preauthorization isn’t a promise your health insurance or plan will cover the cost.”. Checked October 26, 2026.
23. U.S. Department of Health and Human Services, Office for Civil Rights. Does the HIPAA Privacy Rule permit a covered health care provider to e-mail or otherwise electronically exchange protected health information (PHI) with another provider for treatment purposes? (HIPAA FAQ, created December 15, 2008; content last reviewed July 26, 2013). Checked October 26, 2026.
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    “The Privacy Rule allows covered health care providers to share PHI electronically (or in any other form) for treatment purposes, as long as they apply reasonable safeguards when doing so.”.
24. Code of Federal Regulations. 42 CFR 482.43, Condition of participation: Discharge planning (eCFR, Title 42 up to date as of October 23, 2026; Medicare hospital conditions of participation). Checked October 26, 2026.
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    “includes the patient and his or her caregivers/support person(s) as active partners in the discharge planning for post-discharge care”; “The hospital must discharge the patient, and also transfer or refer the patient where applicable, along with all necessary medical information pertaining to the patient’s current course of illness and treatment, post-discharge goals of care, and treatment preferences, at the time of discharge, to the appropriate post-acute care service providers and suppliers, facilities, agencies, and other outpatient service providers and practitioners responsible for the patient’s follow-up or ancillary care.”.
25. Code of Federal Regulations. 34 CFR 300.301, Initial evaluations (eCFR, Title 34 up to date as of October 23, 2026; IDEA Part B). “either a parent of a child or a public agency may initiate a request for an initial evaluation to determine if the child is a child with a disability.”. Checked October 26, 2026.
26. Code of Federal Regulations. 34 CFR 303.303, Referral procedures (eCFR, Title 34 up to date as of October 23, 2026; IDEA Part C, early intervention). Checked October 26, 2026.
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    “The lead agency’s child find system described in § 303.302 must include the State’s procedures for use by primary referral sources for referring a child under the age of three to the part C program.”; “Provide for referring a child as soon as possible, but in no case more than seven days, after the child has been identified”; “Hospitals, including prenatal and postnatal care facilities;”; “Physicians;”; “Other clinics and health care providers;”.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. It is general guidance on running a therapy practice, not legal, compliance, billing or financial advice. HIPAA, state law and each payer’s policy govern a specific referral, and its cases are hypothetical, not DrSensory data or real patients.