Working with IEP Teams as a Private Therapist

This guide is for private-practice OTs, PTs and SLPs whose pediatric clients have, or are being evaluated for, an IEP or 504 plan. The school team decides eligibility and services; you contribute when the parent or school invites you, with written consent on both sides, through a clear report, clinic observations and goals the team may adopt.

Key takeaways

An outside therapist joins an IEP team at the discretion of the parent or the school, and whoever invited the therapist judges the therapist’s expertise.⁠³
IDEA and Section 504’s education rules put their duties on states, public agencies and schools that receive federal funds, not on private practices.⁠^1,4
Educational need and medical necessity are different tests: a school asks whether a child needs special education and related services; Medicaid’s EPSDT benefit covers medically necessary services to correct and ameliorate a condition.⁠^5,6
A private evaluation the parent shares must be considered if it meets the agency’s criteria; the duty is to consider it, not to adopt it.⁠⁷
The school needs the parent’s signed FERPA consent naming the records, purpose and recipient, and the practice’s HIPAA authorization names the information, recipient, purpose and expiration.⁠^8,9
A child who needs only a related service, such as OT, PT or SLP alone, qualifies for an IEP only where state standards treat that service as special education.⁠^5,10
Suggest goals in the school’s terms: the AOTA, APTA and ASHA joint statement says IEP goals belong to the student, not to any discipline.⁠¹¹

School law binds the school, not your practice. IDEA’s Part C serves infants and toddlers through age 2, and Part B serves children and youth ages 3 through 21, so a client aged 18 to 21 may still have an IEP, depending on state law.⁠^1,2

What role does an outside therapist have on a child’s IEP team?

A guest role with a real purpose: you are one of the individuals with knowledge or special expertise regarding the child whom the parent or the school may bring, and the party that invited you decides whether you have that expertise.⁠³ The school must ensure the team includes the parents, regular and special education teachers, an agency representative and someone who can interpret the instructional implications of evaluation results.⁠³

That team writes the IEP, and what you bring enters through two things it must consider: the parents’ concerns and the most recent evaluation.⁠¹²

An outside therapist can	An outside therapist cannot
Evaluate the child and report findings in terms a school team can use	Decide eligibility, services or placement⁠^3,12
Attend when the parent or school invites, in person or by video or phone if the parent and school agree⁠¹³	Set minutes: the IEP states frequency, location and duration, and the team decides them⁠^14,15
Describe what the child does in the clinic, labeled as clinic observation	Bill the school without an agreement; ASHA describes contract SLPs working under an agreement with the district or a contracting agency⁠¹⁶
Suggest goals the team may adopt, reword or decline	Claim that school therapy replaces or duplicates private therapy; a condition that interferes with educational performance may need both clinic-based and school-based PT (APTA Pediatrics fact sheet)⁠¹⁵
Explain the private plan of care	Receive school records without the parent’s written consent, outside narrow exceptions such as a health or safety emergency⁠^8,17

Who decides whether a private therapist can attend the IEP meeting?

Whoever invites you: the regulation leaves the judgment of your expertise to the party, parent or school, that invited you.⁠³ The school’s meeting notice states the purpose, time, location and who is attending, and tells parents they may bring individuals with knowledge or special expertise.⁠¹⁸ So ask the parent to tell the school you are coming, and check that the notice lists you.

Do IDEA and Section 504 apply to a private therapy practice?

No: they set duties for states, districts and schools. IDEA governs how states and public agencies provide special education and related services.⁠¹ The Department of Education’s Section 504 rule on a free appropriate public education binds a recipient of its funds that operates a public elementary or secondary education program, and FERPA applies to educational agencies and institutions that receive its funds.⁠^4,19

Two qualifications apply. HHS has its own Section 504 regulation for each recipient of federal financial assistance from HHS, so such a practice has nondiscrimination duties as a health care provider, which are not the school’s duty to educate.⁠²⁰ And a practice that serves students on contract for a school steps inside the school’s rules: health records kept by a third-party contractor acting for a FERPA-covered school are education records.⁠¹⁷

How do an IEP and a 504 plan differ for therapy services?

An IEP is a written program for a child who qualifies under IDEA; a 504 plan can take different forms. IDEA covers a child with one of its listed disabilities who, by reason of it, needs special education and related services, and the IEP states present levels, measurable annual goals and the services with their frequency, location and duration.⁠^5,14 Under Section 504, an appropriate education can be regular or special education with related aids and services, and placement decisions are made by a group of persons knowledgeable about the child, the evaluation data and the placement options.⁠^4,21 ASHA notes that a 504 plan, unlike an IEP, does not have to be a written document.⁠²² Ask the family which plan the child has first.

What changes when the child attends a private school?

The child may have a services plan instead of an IEP. A child whom the parents place in a private school has no individual right to the services the child would receive in a public school, and the district develops a services plan for what it provides.⁠²³ Private elementary and secondary schools generally receive no Department of Education funds and are not subject to FERPA, so ask the private school how it handles records.⁠¹⁷

How is educational need different from medical necessity?

They answer different questions, so a child can meet one test and not the other. The school asks whether a child with a qualifying disability needs special education and the related services required to benefit from it.⁠^5,24 The IEP must be reasonably calculated to enable progress appropriate in light of the child’s circumstances, and the Department of Education’s Endrew F. guidance stresses that the test is not whether the IEP is ideal.⁠²⁵

A health plan asks whether a treatment is medically necessary under its policy. For children under 21 in Medicaid, the EPSDT benefit requires states to furnish medically necessary services needed to correct and ameliorate health conditions, decided by the state case by case.⁠⁶ For a commercial plan, read its own medical-necessity policy.

Question	School, under IDEA or Section 504	Health plan, for outpatient therapy
The test	Need for special education and related services; an IEP reasonably calculated for appropriate progress⁠^5,25	The plan’s medical-necessity policy; for Medicaid’s EPSDT benefit, services needed to correct and ameliorate a condition⁠⁶
Who decides	The IEP team or the Section 504 group⁠^3,21	The plan, on the clinician’s documentation
Who pays	The school; special education is at no cost to the parents⁠¹⁰	The family’s plan, or the family

Does a school IEP change what a health plan pays for?

Not under school law: IDEA says nothing in it relieves an insurer of an otherwise valid obligation to pay for a child’s services, and Section 504’s education rule says the same.⁠^4,26 Plans still apply their own policies; ASHA publishes an appeal template for a denial that calls speech-language services "educational and not restorative."⁠²⁷ Document the medical reason for private care, and answer a plan’s questions about school services accurately.

Can a school bill a family’s Medicaid or insurance for IEP therapy?

Yes, with written parental consent and limits that protect the family. A school may use a child’s Medicaid to pay for IEP services, but it may not require parents to enroll in Medicaid, must obtain written consent before it first accesses the benefit, and may not use it if that would leave the family paying for covered services the child needs outside school time; it may use private insurance only with the parent’s consent each time.⁠²⁸ The joint AOTA, APTA and ASHA statement adds that Medicaid reimbursement does not determine how an IEP is developed or whether OT, PT or SLP services are provided.⁠¹¹

How do OT, PT and SLP fit differently into school services?

All three are related services under IDEA, but speech-language pathology can also be special education in its own right. IDEA lists speech-language pathology, physical therapy and occupational therapy among related services, and its definition of special education includes speech-language pathology, or any other related service, that state standards treat as special education.⁠^10,24

Point	Occupational therapy	Physical therapy	Speech-language pathology
IDEA definition	Services by a qualified OT, including improving the ability to perform tasks for independent functioning if functions are impaired or lost⁠²⁴	Services provided by a qualified physical therapist⁠²⁴	Includes diagnosis and appraisal of speech or language impairments, and speech and language services⁠²⁴
Special education itself?	Only where state standards treat it so⁠¹⁰	Only where state standards treat it so⁠¹⁰	Where state standards treat it so; the regulation names it explicitly⁠¹⁰
School focus, in each source’s words	Academics, play and leisure, social participation, self-care, and transition or work skills⁠²⁹	Learning and participation goals, not remediation of a medical diagnosis (APTA Pediatrics fact sheet)⁠³⁰	Whether the disorder has an impact on the student’s education⁠³¹
Without an IEP	Students not eligible for special education may receive OT under a 504 plan⁠²⁹	Section 504’s appropriate education can include related aids and services; ask the district⁠⁴	In some states, errors on one or two sounds go through a 504 plan or response to intervention instead⁠²²

The APTA Pediatrics fact sheets cited here are member-produced and state that they do not represent the position of APTA Pediatrics or APTA.⁠^15,30

Why can a child who needs only speech therapy still have an IEP?

Because of how IDEA defines a child with a disability. A child with a qualifying disability who needs only a related service, and not special education, is not a child with a disability under IDEA unless state standards treat that service as special education.⁠⁵ Speech or language impairment is one of IDEA’s categories, and speech-language pathology is the related service the special education definition names.⁠^5,10 So where a state treats SLP as special education, a child needing only speech-language services can qualify; a child needing only OT or only PT qualifies on that basis only where the state treats that service the same way, and may otherwise be served under a 504 plan.⁠^4,5,29 Check the state’s rules first.

Which decisions should you settle before working with an IEP team?

Six, each with a written answer before you send anything or join a meeting:

Decision	What to establish	Record it as
Purpose	Initial evaluation, reevaluation, annual review, a new goal, or a records request	One sentence naming the request and your part in it
Invitation	Who invited you, and whether the school knows	The meeting notice that lists you
Consent	The practice’s authorization to disclose, and the school’s FERPA release	Both signed forms, what each covers and when each ends
Findings	Which statements come from testing, clinic observation, the parent or school records	A report with every finding labeled by its source
Fees	Whether and how you charge the family for the report and meeting time	A fee note the family accepted before the work
Follow-through	What you do after the meeting, and what the school does	A dated chart note of what was sent, decided and still open

Keep every item in the child’s clinical record; a referral spreadsheet or marketing file needs none of it.

Only what the family has agreed to in writing, and different laws govern the two directions. Your practice is subject to HIPAA as a provider only if it is a covered entity, which a provider becomes by transmitting information electronically in a transaction HHS has adopted a standard for, such as a claim to a health plan; otherwise, unless it acts as a covered entity’s business associate, it does not have to comply with the HIPAA Rules.⁠^17,32 The school’s records on children with disabilities are education records under both FERPA and IDEA, and in most cases the HIPAA Privacy Rule does not apply to an elementary or secondary school.⁠¹⁷

Item	Practice to school: HIPAA authorization	School to practice: FERPA consent
Who signs	The parent as a minor’s personal representative, or the adult client⁠^9,33	The parent, or the eligible student at 18⁠^8,34
What it names	The information, who discloses, who receives, each purpose, and an expiration date or event⁠⁹	The records, the purpose, and the party or class of parties receiving them⁠⁸
What else it carries	The right to revoke in writing, whether care depends on signing, and that the recipient may redisclose⁠⁹	A signature and date, which may be electronic⁠⁸

HIPAA does let a covered provider disclose information for treatment to school nurses, physicians or other health care providers without the parent’s authorization, the joint HHS and Department of Education guidance explains.⁠^17,35 That permission is narrow: an IEP team includes teachers and an agency representative, the school needs FERPA consent to reply outside the rule’s exceptions, and more stringent state privacy laws stay in force.⁠^3,8,36 Signed forms in both directions, your authorization and the school’s FERPA release, cover the whole exchange.

Once the school has your report, it is part of the education record, which covers records directly related to a student and maintained by the school, and the school must let parents inspect it on request, before any IEP meeting and within 45 days at most.⁠^34,37

Usually the student, but check each law. Under FERPA, a student becomes an eligible student at 18 or on attending a postsecondary institution, and the parent’s rights transfer to the student.⁠^34,38 Under IDEA, a state may transfer parental rights to the student at the age of majority, and a year ahead the IEP must state that the student has been told.⁠^14,39 Under HIPAA, an adult’s personal representative is whoever has authority under applicable law to make the adult’s health care decisions.⁠³³ An adult-focused practice seeing a student aged 18 to 21 should have the student sign, or see the papers of whoever holds that authority.

What should a private therapy report for an IEP team include?

Findings the team can use, written so a teacher and a parent can follow them. A private evaluation the parent shares must be considered in decisions about the child’s free appropriate public education if it meets the agency’s criteria, and a reevaluation reviews evaluations and information the parents provide.⁠^7,40

Write to the standard the school’s evaluators meet: IDEA requires assessments used for the purposes for which they are valid and reliable, administered by trained and knowledgeable personnel according to the producer’s instructions.⁠⁴¹ Ask the district which criteria it applies to outside evaluations before you test.

Outside therapy report for the IEP team

Child and dates: [student’s name, date of birth, grade and school; dates of the evaluation and of this report]
Requested by, sent to and question answered: [the parent’s request; the recipient named in the authorization; the one question this report answers]
Sources: [standardized tests; clinic observation; parent report; school records the family shared; each labeled]
Tests given: [test name, edition and date; standard scores and percentiles; any departure from standard administration]
In the clinic: [observable function in plain words, such as "copies 3 of 10 words legibly in 5 minutes"]
What it may mean at school: [the routines the finding could affect, framed as questions for the team]
Suggested goals: [two or three, for the team’s consideration]
Private plan of care: [what the practice treats, how often, and its goals outside school]
Not known from the clinic: [what you have not observed, such as the child in a class of 25]
Clinician: [your name, credential, state license number, phone, date and signature]

Leave out service minutes, eligibility conclusions and criticism of school staff. The IEP sets the frequency, location and duration of services, so minutes stated as a requirement ask the team for a decision it makes itself.⁠¹⁴

When is a private evaluation an independent educational evaluation?

Whenever a qualified examiner not employed by the school district conducts it; what changes is who pays. A parent who disagrees with the district’s evaluation can request an independent educational evaluation at public expense, and the district must then ensure one is provided or file for a due process hearing to show its own evaluation is appropriate.⁠⁷ At public expense, the criteria, including the location of the evaluation and the examiner’s qualifications, are the same as those the district uses for its own evaluations, to the extent they fit the parent’s right.⁠⁷ If a district asks you to conduct one, agree its terms in writing first.

How do you suggest IEP goals a school team can adopt?

Write them as the school writes goals: measurable, annual, tied to school routines, and offered for the team to change. An IEP contains measurable annual goals, academic and functional, and states how progress is measured and when progress reports are provided.⁠¹⁴ The joint AOTA, APTA and ASHA statement adds that a goal should have a clear focus, describe measurable progress, be achievable in school routines, connect to the student’s educational goals and include a time frame or criterion.⁠¹¹

Do not write one goal per discipline. The same statement notes that IDEA does not specify discipline-specific goals; its sample goal, independently completing half of a written assignment in the time classmates use, is shared by the PT, the OT, the SLP and both teachers.⁠¹¹

Suggested goal, for the team’s consideration

School routine: [where the difficulty shows at school, as the parent or teacher describes it]
Present level: [what the child does now, the measure, and its source]
Goal: "By [month and year], during [routine], [child] [observable behavior] in [number] of [number] opportunities, measured by [work samples, teacher report or observation]."
What the clinic adds: [strategies or carryover from private therapy]

These hypothetical examples show the translation; each needs the child’s own data:

Discipline	Clinic finding	Goal suggestion in school terms
OT	Hand fatigue after 3 minutes of copying	During independent writing, completes [number] short answers a reader can identify, in the time classmates use
PT	Uses a handrail and stops twice on a 12-step flight	Moves between classes on the stairs with the class in [number] of [number] transitions
SLP	Low intelligibility to unfamiliar listeners	In morning share, gives a three-sentence account a classmate understands without repetition in [number] of [number] turns

What should you prepare before an IEP meeting as an outside therapist?

The paperwork and the purpose, a week or more ahead:

The invitation. Confirm who invited you; the notice states the purpose, time, location and who is attending.⁠¹⁸
The kind of meeting. An initial evaluation needs the parent’s informed consent; a reevaluation happens at least every 3 years and not more than once a year unless the parent and school agree; an IEP is reviewed at least yearly.⁠^12,42,43
Both consents. Your signed authorization, and the district’s FERPA release if you need records back.⁠^8,9
The school’s evaluation. Read it first; the parent may inspect the child’s records before any IEP meeting.⁠³⁷
A one-page summary. Labeled findings and two or three goals, sent by the route the consent names.
How you attend. In person, or by video or phone if the parent and school agree.⁠¹³
The fee. A written note of what you charge; the insurance and fees guide covers estimates for self-pay families.

What should an outside therapist say, and avoid saying, at the meeting?

Say what you measured and saw, labeled by its source, and leave decisions to the team. Useful lines:

"In my clinic, over [number] sessions, I saw [observable function]. That is clinic observation, not school observation."
"Here are two goals the team might consider; please reword them to fit the classroom."

Better left unsaid:

"The child needs [number] minutes a week at school." The team decides the amount, frequency, location and duration of related services.⁠¹⁵
"Private therapy can replace school services," or the reverse. A medical condition that interferes with educational performance may need both clinic-based and school-based PT, an APTA Pediatrics fact sheet notes, and ASHA names private therapy practitioners among the community providers school SLPs work with.⁠^15,31
"The child qualifies," or "does not qualify." Federal, state and local guidelines set the criteria.⁠⁴⁴
A promise of results, or criticism of school staff; describe differences in data instead.

What if your findings disagree with the school’s evaluation?

Explain the difference in data, naming the test, setting and date behind each result, and leave the decision with the team and the family. If the parent disagrees with the school’s evaluation, IDEA gives the parent, not the therapist, the right to request an independent educational evaluation at public expense.⁠⁷ When the school proposes or refuses a change, its written notice to the parents describes each evaluation, record or report it used and the options it rejected, which tells the family whether your report was among them.⁠⁴⁵

Can a school therapist also treat the same child privately?

For SLPs, ASHA sets conditions: the family is fully informed of the school’s and the private practice’s services and free to choose, the costs are clear, and the SLP tells the school administrator and honors any non-compete agreement.⁠¹⁶ That guidance is ASHA’s; OTs and PTs should check their own code of ethics, state board and employer’s policy.

What happens after the IEP meeting, and what should you record?

The school writes the decisions; you record your part and adjust your plan. The parent receives a copy of the IEP at no cost, and changes after the annual meeting can be made by written amendment if the parent and the school agree.⁠^12,18 Record in the chart:

the date, who attended and how;
what was sent, to whom, under which consent, and when it expires;
what the parent reports the team decided;
changes to your plan of care, so your goals complement the school’s rather than repeat them;
the next date: the annual review or a reevaluation.

An authorization names its recipient and an expiration, so a new school contact or school year can need a new form.⁠⁹

How do early intervention and adulthood change the IEP work?

Before 3, early intervention under Part C runs on an IFSP, a written plan for the child and family, and from 16 the IEP turns toward adult life.⁠^14,46 An IEP or an IFSP must be in effect by the child’s third birthday, and for a child who was in Part C, the invitation to the first IEP meeting goes to the Part C service coordinator at the parent’s request.⁠^3,47 The NICU follow-up guide covers the infant years.

From the first IEP in effect when the student turns 16, the IEP includes measurable postsecondary goals and transition services.⁠¹⁴ Eligibility ends with a regular high school diploma, or where state law limits public education for ages 18 to 21, and a student leaving for either reason receives a summary of academic achievement and functional performance with recommendations.⁠^2,40 An adult practice taking on a young adult can ask for that summary; the pediatric-to-adult transition guide covers the handoff.

How should a practice describe school coordination to families?

Plainly, as something done with the family’s permission, never as a route to school services.

Service page or intake wording: "With your written permission, we can share our reports with your child’s school team, suggest goals the team may consider, and join an IEP or 504 meeting when you or the school invite us. The school decides eligibility and school services. Report and meeting time are [included, or charged at our stated rate], and we tell you the cost before we start."

Avoid "IEP advocacy," "we get your child the services they need" and "school therapy is not enough": the school team makes those decisions, and you have not evaluated the school’s services.⁠³ Use the same facts on your pediatric service pages, in your intake call script and, for a clinic with a paid DrSensory listing, in the description written in the clinic’s own words. Families search DrSensory’s directory at no cost for occupational, physical and speech therapy clinics for children and adults; every clinic’s basic listing is free, and so is claiming it.

How does working with an IEP team play out for one child?

One decision at a time, as this hypothetical case shows.

Hypothetical. A private SLP has treated a 7-year-old for speech sound errors for five months. The school is reevaluating him, and his mother asks the SLP to join the meeting; the notice lists the SLP as attending by video at the parent’s invitation.

The mother signs the practice’s authorization to send the evaluation summary and latest progress note to the district’s IEP team, expiring at the end of the school year, and the district’s release for the school’s new evaluation. The school’s single-word scores are close to the SLP’s, but its classroom observation shows fewer errors than she hears in clinic conversation.

Her two-page report labels each finding by source and suggests a morning-share goal and a reading-aloud goal, with no minutes. At the meeting she explains why conversation samples differ from single words and leaves after 20 minutes. The team adopts a reworded morning-share goal and sets its own service time; the prior written notice lists her report among those used. She records what was sent and decided, and bills the fee agreed in writing beforehand.

The figures are illustrations, not benchmarks. For an OT or PT the steps are the same; what changes is whether the child can qualify for an IEP on that service alone.

Frequently asked questions

Does the school have to follow my evaluation?

It has to consider it, not follow it: a private evaluation the parent shares must be considered in decisions about the child’s free appropriate public education if it meets the agency’s criteria.⁠⁷

Does a family need the school’s permission for a private evaluation?

No. A family can arrange a private evaluation at any time; for a child with a disability, IDEA states the parents’ right to obtain an independent educational evaluation, and one they share is considered if it meets the agency’s criteria.⁠⁷

Who pays for my time at an IEP meeting?

The family, or the district if it engages you in writing. Special education is at no cost to parents, but that covers the school’s services, not a private practice’s fees.⁠¹⁰

Can I attend an IEP meeting by phone or video?

Yes, if the parent and the school agree; IDEA allows alternative means such as video conferences and conference calls.⁠¹³

How often does an IEP team meet?

At least yearly to review the IEP, with a reevaluation at least every 3 years and no more than once a year unless the parent and school agree otherwise.⁠^12,43

Can a parent give me a copy of the IEP?

Yes. The school gives the parent a copy at no cost, and FERPA’s consent rule governs what a school discloses, not what a parent shares.⁠^8,18

How long does a school have to finish an initial evaluation?

Within 60 days of the parent’s consent, or the state’s own timeframe, and either a parent or the school can request it.⁠⁴⁸

Can I call the child’s teacher directly?

Get the parent’s written permission covering that contact first: HIPAA’s treatment permission reaches health care providers, and outside FERPA’s exceptions the school needs the parent’s consent before sharing anything from the child’s records.⁠^8,17

Sources

U.S. Department of Education. About IDEA (IDEA website). Checked October 23, 2026.
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“The IDEA governs how states and public agencies provide early intervention, special education, and related services”; “Infants and toddlers, birth through age 2, with disabilities and their families receive early intervention services under IDEA Part C. Children and youth ages 3 through 21 receive special education and related services under IDEA Part B.”.
eCFR. 34 CFR 300.102 Limitation—exception to FAPE for certain ages (IDEA Part B regulations, paragraph (a)). Checked October 23, 2026.
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“Children aged 3, 4, 5, 18, 19, 20, or 21 in a State to the extent that its application to those children would be inconsistent with State law or practice”; “Children with disabilities who have graduated from high school with a regular high school diploma”.
eCFR. 34 CFR 300.321 IEP Team (IDEA Part B regulations, paragraphs (a), (c) and (f)). Checked October 23, 2026.
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“The public agency must ensure that the IEP Team for each child with a disability includes”; “The parents of the child;”; “Not less than one regular education teacher of the child (if the child is, or may be, participating in the regular education environment)”; “Not less than one special education teacher of the child, or where appropriate, not less than one special education provider of the child”; “A representative of the public agency who”; “An individual who can interpret the instructional implications of evaluation results”; “At the discretion of the parent or the agency, other individuals who have knowledge or special expertise regarding the child, including related services personnel as appropriate”; “The determination of the knowledge or special expertise of any individual described in paragraph (a)(6) of this section must be made by the party (parents or public agency) who invited the individual to be a member of the IEP Team”; “In the case of a child who was previously served under Part C of the Act, an invitation to the initial IEP Team meeting must, at the request of the parent, be sent to the Part C service coordinator or other representatives of the Part C system”.
eCFR. 34 CFR 104.33 Free appropriate public education (Section 504 regulations of the U.S. Department of Education, paragraphs (a), (b)(1) and (c)). Checked October 23, 2026.
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“A recipient that operates a public elementary or secondary education program or activity shall provide a free appropriate public education to each qualified handicapped person who is in the recipient’s jurisdiction”; “the provision of an appropriate education is the provision of regular or special education and related aids and services”; “Nothing in this section shall be construed to relieve an insurer or similar third party from an otherwise valid obligation to provide or pay for services provided to a handicapped person”.
eCFR. 34 CFR 300.8 Child with a disability (IDEA Part B regulations, paragraphs (a) and (c)(11)). Checked October 23, 2026.
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“and who, by reason thereof, needs special education and related services”; “but only needs a related service and not special education, the child is not a child with a disability under this part”; “If, consistent with § 300.39(a)(2), the related service required by the child is considered special education rather than a related service under State standards, the child would be determined to be a child with a disability”; “Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance”.
Centers for Medicare & Medicaid Services, Medicaid.gov. Early and Periodic Screening, Diagnostic, and Treatment (benefit overview). Checked October 23, 2026.
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“provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid”; “States are required to furnish all 1905(a) Medicaid coverable, appropriate, and medically necessary services needed to correct and ameliorate health conditions”; “It is the responsibility of states to determine medical necessity on a case-by-case basis”.
eCFR. 34 CFR 300.502 Independent educational evaluation (IDEA Part B regulations, paragraphs (a) through (c) and (e)). Checked October 23, 2026.
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“The parents of a child with a disability have the right under this part to obtain an independent educational evaluation of the child”; “Independent educational evaluation means an evaluation conducted by a qualified examiner who is not employed by the public agency responsible for the education of the child in question”; “A parent has the right to an independent educational evaluation at public expense if the parent disagrees with an evaluation obtained by the public agency”; “File a due process complaint to request a hearing to show that its evaluation is appropriate; or”; “Ensure that an independent educational evaluation is provided at public expense”; “or shares with the public agency an evaluation obtained at private expense, the results of the evaluation”; “Must be considered by the public agency, if it meets agency criteria, in any decision made with respect to the provision of FAPE to the child”; “including the location of the evaluation and the qualifications of the examiner, must be the same as the criteria that the public agency uses when it initiates an evaluation”.
eCFR. 34 CFR 99.30 Under what conditions is prior consent required to disclose information? (FERPA regulations, paragraphs (a), (b) and (d)). Checked October 23, 2026.
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“The parent or eligible student shall provide a signed and dated written consent before an educational agency or institution discloses personally identifiable information from the student’s education records, except as provided in § 99.31”; “Specify the records that may be disclosed;”; “State the purpose of the disclosure; and”; “Identify the party or class of parties to whom the disclosure may be made”; “under this part may include a record and signature in electronic form”.
eCFR. 45 CFR 164.508 Uses and disclosures for which an authorization is required (HIPAA Privacy Rule, paragraph (c)). Checked October 23, 2026.
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“A description of the information to be used or disclosed that identifies the information in a specific and meaningful fashion”; “The name or other specific identification of the person(s), or class of persons, to whom the covered entity may make the requested use or disclosure”; “A description of each purpose of the requested use or disclosure”; “An expiration date or an expiration event that relates to the individual or the purpose of the use or disclosure”; “Signature of the individual and date. If the authorization is signed by a personal representative of the individual, a description of such representative’s authority to act for the individual must also be provided”; “The individual’s right to revoke the authorization in writing”; “The ability or inability to condition treatment, payment, enrollment or eligibility for benefits on the authorization”; “The potential for information disclosed pursuant to the authorization to be subject to redisclosure by the recipient and no longer be protected by this subpart”.
eCFR. 34 CFR 300.39 Special education (IDEA Part B regulations, paragraph (a)). Checked October 23, 2026.
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“Special education means specially designed instruction, at no cost to the parents, to meet the unique needs of a child with a disability”; “Speech-language pathology services, or any other related service, if the service is considered special education rather than a related service under State standards”.
American Occupational Therapy Association, American Physical Therapy Association and American Speech-Language-Hearing Association. Joint Statement on Interprofessional Collaborative Goals in School-Based Practice (2022). Checked October 23, 2026.
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“have a clear focus on the area to be addressed”; “include a description of measurable progress”; “be achievable in the context of school routines”; “connect to the student’s overarching educational goals”; “include a time frame or criterion for achievement”; “independently completing 50% of a written assignment in the same amount of time used by his classmates”; “it does not specify that each service provider writes discipline-specific goals. IEP goals are individualized to the student and do not belong to any specific discipline”; “Medicaid reimbursement does not determine how an IEP is developed or if occupational therapy, physical therapy, and speech-language pathology services will be provided”.
eCFR. 34 CFR 300.324 Development, review, and revision of IEP (IDEA Part B regulations, paragraphs (a) and (b)). Checked October 23, 2026.
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“In developing each child’s IEP, the IEP Team must consider”; “The concerns of the parents for enhancing the education of their child”; “The results of the initial or most recent evaluation of the child”; “may agree not to convene an IEP Team meeting for the purposes of making those changes, and instead may develop a written document to amend or modify the child’s current IEP”; “Reviews the child’s IEP periodically, but not less than annually, to determine whether the annual goals for the child are being achieved”.
eCFR. 34 CFR 300.328 Alternative means of meeting participation (IDEA Part B regulations). “the parent of a child with a disability and a public agency may agree to use alternative means of meeting participation, such as video conferences and conference calls”. Checked October 23, 2026.
eCFR. 34 CFR 300.320 Definition of individualized education program (IDEA Part B regulations, paragraphs (a) through (c)). Checked October 23, 2026.
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“A statement of the child’s present levels of academic achievement and functional performance”; “A statement of measurable annual goals, including academic and functional goals designed to”; “How the child’s progress toward meeting the annual goals described in paragraph (2) of this section will be measured”; “When periodic reports on the progress the child is making toward meeting the annual goals”; “the anticipated frequency, location, and duration of those services and modifications”; “Beginning not later than the first IEP to be in effect when the child turns 16, or younger if determined appropriate by the IEP Team”; “Beginning not later than one year before the child reaches the age of majority under State law, the IEP must include a statement that the child has been informed of the child’s rights under Part B of the Act, if any, that will transfer to the child”.
APTA Academy of Pediatric Physical Therapy. Educationally Relevant Physical Therapy – Part II: Determining a Student’s Need for School-Based PT under IDEA (member-produced fact sheet, June 2021, which states that it does not represent the position of APTA Pediatrics or of the American Physical Therapy Association). Checked October 23, 2026.
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“A medical diagnosis, standing alone, is not sufficient nor required to determine disability or specific special education category”; “A medical condition that does not interfere with educational performance may require clinic-based PT, but not school-based PT. However, a medical condition that interferes with educational performance may require both clinic-based and school-based PT.”; “The IEP goals belong to the student, and not a specific discipline or provider”; “The IEP team also decides the amount, frequency, location, and duration of related services to be provided”; “They are not intended to represent the position of APTA Pediatrics or of the American Physical Therapy Association.”.
American Speech-Language-Hearing Association. Medicaid, Private Practice, and Independent Contracting in School Services (School Services Frequently Asked Questions). Checked October 23, 2026.
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“Covered Medicaid benefits include speech-language pathology services identified in the child’s individualized education program (IEP) or individualized family service plan (IFSP)”; “The persons served professionally must be (a) fully informed of services available from the practitioner’s primary employment setting as well as those from the private practice or other practice environment and (b) given freedom to choose whether and from whom they will obtain professional services”; “The costs associated with obtaining services from the practitioner’s primary employment setting versus those associated with the private practice must be made clear”; “Practitioners accepting cases in a private setting from their primary place of employment must inform the administrator at their primary employment setting of their intent”; “Practitioners must honor any non-compete contractual agreements stipulated by the employer”; “As an independent contractor, the SLP works under an agreement or contract with the school district or agency that contracts with the public school or charter school”.
U.S. Department of Health and Human Services and U.S. Department of Education. Joint Guidance on the Application of the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to Student Health Records (December 2019 update; the guidance states it does not have the force and effect of law). Checked October 23, 2026.
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“Records that educational agencies and institutions maintain on children with disabilities, including records of children referred under the Individuals with Disabilities Education Act (IDEA), are also covered as education records under both FERPA and IDEA”; “Private and religious schools at the elementary and secondary levels generally do not receive funds from the U.S. Department of Education and are, therefore, not subject to FERPA”; “In most cases, the HIPAA Privacy Rule does not apply to an elementary or secondary school”; “Health records that directly relate to students and are maintained by a health care provider, such as a third party contractor, acting for a FERPA-covered elementary or secondary school, would qualify as education records subject to FERPA regardless of whether the health care provider is employed by the school”; “The HIPAA Privacy Rule allows covered health care providers to disclose PHI about students to school nurses, physicians, or other health care providers for several purposes, without the authorization of the student or student’s parent”; “HIPAA permits covered entities to disclose PHI for treatment purposes, without the authorization of the student or student’s parent”; “a school nurse or other school official may disclose PII from a non-eligible student’s education records to the student’s family physician, without the written consent of the parent, where a health or safety emergency exists”; “Covered transactions are those for which the U.S. Department of Health and Human Services has adopted a standard, such as health care claims submitted to a health plan”.
eCFR. 34 CFR 300.322 Parent participation (IDEA Part B regulations, paragraphs (b) and (f)). Checked October 23, 2026.
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“Indicate the purpose, time, and location of the meeting and who will be in attendance”; “Inform the parents of the provisions in § 300.321(a)(6) and (c) (relating to the participation of other individuals on the IEP Team who have knowledge or special expertise about the child)”; “The public agency must give the parent a copy of the child’s IEP at no cost to the parent”.
eCFR. 34 CFR 99.1 To which educational agencies or institutions do these regulations apply? (FERPA regulations, paragraph (a)). “this part applies to an educational agency or institution to which funds have been made available under any program administered by the Secretary”. Checked October 23, 2026.
eCFR. 45 CFR 84.2 Application (Section 504 regulations of the U.S. Department of Health and Human Services, as revised May 9, 2024, paragraph (a)). “This part applies to each recipient of Federal financial assistance from the Department and to the recipient’s programs or activities that involve individuals with disabilities in the United States”. Checked October 23, 2026.
eCFR. 34 CFR 104.35 Evaluation and placement (Section 504 regulations of the U.S. Department of Education, paragraph (c)). Checked October 23, 2026.
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“draw upon information from a variety of sources, including aptitude and achievement tests, teacher recommendations, physical condition, social or cultural background, and adaptive behavior”; “ensure that the placement decision is made by a group of persons, including persons knowledgeable about the child, the meaning of the evaluation data, and the placement options”.
American Speech-Language-Hearing Association. Individualized Education Programs (IEPs) in School Services (School Services Frequently Asked Questions). Checked October 23, 2026.
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“Section 504 requires that students be provided with a reasonable accommodation, which is different than that of IDEA, which requires provision of specialized individualized instruction”; “The 504 plan, unlike an individualized education program (IEP), does not have to be a written document, and rules for creation, review, and revision can be different between school districts and states”; “In some states, speech sound disorders, consisting of errors with only one or two sounds, are addressed through a 504 plan or through response to intervention (RTI) rather than through an IEP”.
eCFR. 34 CFR 300.137 Equitable services determined (IDEA Part B regulations, paragraphs (a) and (c)). Checked October 23, 2026.
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“No parentally-placed private school child with a disability has an individual right to receive some or all of the special education and related services that the child would receive if enrolled in a public school”; “Initiate and conduct meetings to develop, review, and revise a services plan for the child”.
eCFR. 34 CFR 300.34 Related services (IDEA Part B regulations, paragraphs (a) and (c)). Checked October 23, 2026.
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“Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy”; “Means services provided by a qualified occupational therapist”; “Improving ability to perform tasks for independent functioning if functions are impaired or lost”; “Physical therapy means services provided by a qualified physical therapist”; “Diagnosis and appraisal of specific speech or language impairments”; “Provision of speech and language services for the habilitation or prevention of communicative impairments”.
U.S. Department of Education. Questions and Answers (Q&A) on U. S. Supreme Court Case Decision Endrew F. v. Douglas County School District Re-1 (December 7, 2017). Checked October 23, 2026.
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“a school must offer an IEP [individualized education program] that is reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances”; “Generally, this means that school personnel will make decisions that are informed by their own expertise, the progress of the child, the child’s potential for growth, and the views of the child’s parents”; “any review of an IEP must consider whether the IEP is reasonably calculated to ensure such progress, not whether it would be considered ideal”.
eCFR. 34 CFR 300.103 FAPE—methods and payments (IDEA Part B regulations, paragraph (b)). “Nothing in this part relieves an insurer or similar third party from an otherwise valid obligation to provide or to pay for services provided to a child with a disability”. Checked October 23, 2026.
American Speech-Language-Hearing Association. Appeal Template: Educational Versus Restorative Services (a letter template for appealing a health plan denial). “denied payment for this service because it is considered "educational and not restorative,"”; “Speech-language pathology services are not educational in nature, but instead are a health-related service, in this case, provided for treatment of a medical condition”. Checked October 23, 2026.
eCFR. 34 CFR 300.154 Methods of ensuring services (IDEA Part B regulations, paragraphs (d) and (e)). Checked October 23, 2026.
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“A public agency may use the Medicaid or other public benefits or insurance programs in which a child participates to provide or pay for services required under this part”; “May not require parents to sign up for or enroll in public benefits or insurance programs in order for their child to receive FAPE under Part B of the Act”; “Result in the family paying for services that would otherwise be covered by the public benefits or insurance program and that are required for the child outside of the time the child is in school”; “Prior to accessing a child’s or parent’s public benefits or insurance for the first time, and after providing notification to the child’s parents consistent with paragraph (d)(2)(v) of this section, must obtain written, parental consent”; “Prior to accessing a child’s or parent’s public benefits or insurance for the first time, and annually thereafter, must provide written notification”; “a public agency may access the parents’ private insurance proceeds only if the parents provide consent consistent with § 300.9”; “Each time the public agency proposes to access the parents’ private insurance proceeds, the agency must”; “Inform the parents that their refusal to permit the public agency to access their private insurance does not relieve the public agency of its responsibility to ensure that all required services are provided at no cost to the parents”.
American Occupational Therapy Association. What is the Role of the School-Based Occupational Therapy Practitioner? Questions & Answers for School Administrators (developed by the AOTA Workgroup of Leaders in State Departments of Education, 2017). Checked October 23, 2026.
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“In schools, occupational therapy practitioners focus on academics, play and leisure, social participation, self-care skills (ADLs or Activities of Daily Living), and transition/ work skills”; “Evaluation services assist the Individualized Education Program (IEP) team with identifying the presence of a disability and whether there is an educational need for occupational therapy services”; “Students who are not eligible for special education may receive occupational therapy services under a Section 504 plan”.
APTA Academy of Pediatric Physical Therapy. Providing Physical Therapy Under the Individuals with Disabilities Education Act (IDEA - Part B): An Overview of School-Based Physical Therapy (member-produced fact sheet, May 2021, which states that it does not represent the position of APTA Pediatrics or of APTA). Checked October 23, 2026.
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“Intervention in the education setting is not provided to remediate medical diagnoses and or physical impairments under IDEA, but instead to help the student achieve his/her learning and participation goals despite the existing diagnosis driven impairments”; “They are not intended to represent the position of APTA Academy of Pediatric Physical Therapy or of the APTA.”.
American Speech-Language-Hearing Association. Roles and Responsibilities of Speech-Language Pathologists in Schools (professional issues statement, 2010). Checked October 23, 2026.
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“The litmus test for roles assumed by SLPs with students with disabilities is whether the disorder has an impact on the education of students”; “SLPs work with a variety of individuals and agencies (e.g., physicians, private therapy practitioners, social service agencies, private schools, and vocational rehabilitation) who may be involved in teaching or providing services to children and youth”.
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 23, 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”.
eCFR. 45 CFR 164.502 Uses and disclosures of protected health information: General rules (HIPAA Privacy Rule, paragraph (g)). Checked October 23, 2026.
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“a covered entity must, except as provided in paragraphs (g)(3) and (g)(5) of this section, treat a personal representative as the individual for purposes of this subchapter”; “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”; “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”.
eCFR. 34 CFR 99.3 What definitions apply to these regulations? (FERPA regulations). “Directly related to a student; and”; “Maintained by an educational agency or institution or by a party acting for the agency or institution”; “Eligible student means a student who has reached 18 years of age or is attending an institution of postsecondary education”. Checked October 23, 2026.
eCFR. 45 CFR 164.506 Uses and disclosures to carry out treatment, payment, or health care operations (HIPAA Privacy Rule, paragraph (c)). “A covered entity may disclose protected health information for treatment activities of a health care provider”. Checked October 23, 2026.
eCFR. 45 CFR 160.203 General rule and exceptions (HIPAA preemption of State law, paragraph (b)). “The provision of State law relates to the privacy of individually identifiable health information and is more stringent than a standard, requirement, or implementation specification adopted under subpart E of part 164 of this subchapter”. Checked October 23, 2026.
eCFR. 34 CFR 300.613 Access rights (IDEA Part B regulations, paragraph (a)). “The agency must comply with a request without unnecessary delay and before any meeting regarding an IEP”; “and in no case more than 45 days after the request has been made”. Checked October 23, 2026.
eCFR. 34 CFR 99.5 What are the rights of students? (FERPA regulations, paragraph (a)). “When a student becomes an eligible student, the rights accorded to, and consent required of, parents under this part transfer from the parents to the student”. Checked October 23, 2026.
eCFR. 34 CFR 300.520 Transfer of parental rights at age of majority (IDEA Part B regulations, paragraph (a)). Checked October 23, 2026.
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“A State may provide that, when a child with a disability reaches the age of majority under State law that applies to all children”; “All rights accorded to parents under Part B of the Act transfer to the child”.
eCFR. 34 CFR 300.305 Additional requirements for evaluations and reevaluations (IDEA Part B regulations, paragraphs (a) and (e)). Checked October 23, 2026.
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“As part of an initial evaluation (if appropriate) and as part of any reevaluation under this part”; “Review existing evaluation data on the child, including”; “Evaluations and information provided by the parents of the child”; “Observations by teachers and related services providers”; “a public agency must provide the child with a summary of the child’s academic achievement and functional performance, which shall include recommendations on how to assist the child in meeting the child’s postsecondary goals”.
eCFR. 34 CFR 300.304 Evaluation procedures (IDEA Part B regulations, paragraphs (b) and (c)). Checked October 23, 2026.
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“Use a variety of assessment tools and strategies to gather relevant functional, developmental, and academic information about the child, including information provided by the parent”; “Are used for the purposes for which the assessments or measures are valid and reliable”; “Are administered by trained and knowledgeable personnel”; “Are administered in accordance with any instructions provided by the producer of the assessments”.
eCFR. 34 CFR 300.300 Parental consent (IDEA Part B regulations, paragraphs (a) and (b)). “obtain informed consent, consistent with § 300.9, from the parent of the child before conducting the evaluation”; “Parental consent for initial evaluation must not be construed as consent for initial provision of special education and related services”. Checked October 23, 2026.
eCFR. 34 CFR 300.303 Reevaluations (IDEA Part B regulations, paragraph (b)). “May occur not more than once a year, unless the parent and the public agency agree otherwise”; “Must occur at least once every 3 years, unless the parent and the public agency agree that a reevaluation is unnecessary”. Checked October 23, 2026.
American Speech-Language-Hearing Association. Eligibility and Dismissal Criteria in School Services (School Services Frequently Asked Questions). “ASHA does not recommend specific criteria for eligibility or dismissal of services for educational settings. Federal, state, and/or local guidelines determine criteria.”; “State and/or local school education agencies may apply different interpretations to the phrase "adversely affects educational performance"”. Checked October 23, 2026.
eCFR. 34 CFR 300.503 Prior notice by the public agency; content of notice (IDEA Part B regulations, paragraphs (a) and (b)). Checked October 23, 2026.
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“Written notice that meets the requirements of paragraph (b) of this section must be given to the parents of a child with a disability a reasonable time before the public agency”; “A description of each evaluation procedure, assessment, record, or report the agency used as a basis for the proposed or refused action”; “A description of other options that the IEP Team considered and the reasons why those options were rejected”.
eCFR. 34 CFR 303.20 Individualized family service plan (IDEA Part C regulations). “Individualized family service plan or IFSP means a written plan for providing early intervention services to an infant or toddler with a disability under this part and the infant’s or toddler’s family”. Checked October 23, 2026.
eCFR. 34 CFR 300.101 Free appropriate public education (FAPE) (IDEA Part B regulations, paragraphs (a) and (b)). “A free appropriate public education must be available to all children residing in the State between the ages of 3 and 21, inclusive”; “An IEP or an IFSP is in effect for the child by that date”. Checked October 23, 2026.
eCFR. 34 CFR 300.301 Initial evaluations (IDEA Part B regulations, paragraphs (b) and (c)). Checked October 23, 2026.
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“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”; “Must be conducted within 60 days of receiving parental consent for the evaluation; or”; “If the State establishes a timeframe within which the evaluation must be conducted, within that timeframe”.

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. States and school districts set their own procedures under IDEA and Section 504, and state privacy law can be stricter than HIPAA, so confirm the rules that apply with the district and your own adviser.

Working with IEP teams as an outside therapist