Illinois therapy practice guide: PT, OT and SLP

For OT, PT and SLP clinics in Illinois: one department licenses all three disciplines; a patient may start physical therapy without a referral, and the therapist notifies the patient’s treating health care professional within 5 business days; Illinois Medicaid covers children’s therapy under EPSDT and adults within its own rules; and telehealth follows the patient’s location.⁠^1,2,3,4

Who licenses OTs, PTs and SLPs in Illinois?

The Illinois Department of Financial and Professional Regulation licenses all three disciplines, and each profession has its own statute, renewal date and continuing-education requirement.⁠^1,5,6 A clinic that employs more than one discipline still keeps three registers, not one.

Physical therapists, occupational therapists and speech-language pathologists all answer to the Illinois Department of Financial and Professional Regulation, each profession under its own statute and continuing-education rule.⁠^1,5,6 A license is a state authorization; a national certification (NBCOT for occupational therapy, the ASHA certificate for speech-language pathology, the NPTE for physical therapy) is a different thing and does not replace it. Compact privileges for practitioners licensed elsewhere are covered under telehealth below.

What does an Illinois license renewal require?

The department sets a separate cycle and hours for each profession, listed in the table above, and the register template at the end of this page tracks them per clinician.⁠^1,5,6 A renewal missed is a lapse, and the department’s own rules say what a lapsed licensee may and may not do; the clinic reads those rules before a clinician’s renewal date passes, not after.

Can a patient see an Illinois PT, OT or SLP without a referral?

State law answers this discipline by discipline, and a payer may still require a referral the law does not. For physical therapy, a physical therapist may treat a patient with or without a referral; without one, the therapist notifies the patient’s treating health care professional within 5 business days after the first visit, refers the patient on if there is no measurable or functional improvement after 10 visits or 15 business days, whichever comes first, and needs a health care professional’s written authorization for wound debridement.⁠^2,7,8 For occupational therapy, an occupational therapist or assistant may evaluate, start and provide occupational therapy without a referral, and needs none for children and youths served in a school-based or educational setting, including the child’s home; the therapist refers the patient on if there is no measurable or functional improvement after 10 visits or 15 business days, whichever comes first.⁠^33,34,35 From January 1, 2027, Public Act 104-591 rewrites the referral section: an occupational therapist may provide services within the licensee’s scope of practice without a referral, needs none for consultation, habilitation, screening, education, wellness, prevention, environmental assessments and work-related ergonomic services, and the refer-on point becomes 10 visits without measurable or functional improvement.⁠^33,34,35 For speech-language pathology, the licensure act defines the practice of speech-language pathology and requires a license to practice it, and requires a physician’s written referral and direct authorization before an SLP performs a laryngoscopic procedure on a patient with a voice, swallowing or velopharyngeal disorder.⁠^36,37,38 Illinois Medicaid, as a payer, requires a signed and dated practitioner’s order for therapy services.⁠⁷

The payer’s rule is separate. Medicare pays for outpatient therapy under a plan of care certified by a physician or nonphysician practitioner, and the regulation’s 2025 text lets a signed order or referral on file, with the plan delivered within 30 days of the initial evaluation, stand in for that signature on an initial plan.⁠¹⁵ Illinois Medicaid’s referral and prior-authorization rules are in the next section. A commercial plan’s rule is in its member contract and provider manual, and the clinic keeps a copy of each.

How does Illinois Medicaid pay for pediatric and adult therapy?

Illinois Medicaid is run by the Illinois Department of Healthcare and Family Services, and a clinic enrolls through its provider enrollment route before it bills.⁠³⁹ For children, the federal EPSDT benefit requires the state to cover services that correct or ameliorate a condition found at a screening, whether or not the state plan covers them for adults.⁠⁴⁰ For children through age 20, Illinois Medicaid has required prior approval for physical and occupational therapy since November 16, 2015, while speech therapy for a child through age 20 is exempt from prior approval, as is any therapy evaluation visit.⁠^3,4

Illinois Medicaid covers medically necessary occupational, physical and speech therapy evaluations and treatment when an illness, disability or infirmity limits functional performance and the therapy improves functional skills performance. Adult therapy has no annual visit cap but needs the Department’s prior approval, required since July 1, 2012.⁠^9,10 Fee-for-service Illinois Medicaid requires the Department’s prior approval for all therapy except Medicare-approved services, services paid by a managed care plan, speech therapy for a child through age 20 and evaluation visits, requested on Form HFS 3701T with a current signed and dated practitioner order. Prior approval requests for a managed care member go to the member’s plan.⁠^41,42 Most Illinois Medicaid members are in managed care through HealthChoice Illinois, its YouthCare plan for youth in the care of the Department of Children and Family Services, or the Medicare Medicaid Alignment Initiative. A clinic enrolls in IMPACT before contracting with each plan.⁠⁴³ The fee schedule is published by the agency, and a clinic reads the current file rather than a remembered rate.⁠⁴⁴

How does Illinois Medicaid want OT, PT and SLP claims coded?

Illinois Medicaid therapy claims carry CPT procedure codes with modifier GP for physical therapy, GO for occupational therapy and GN for speech therapy. Prior approval is requested on Form HFS 3701T, and a claim must match the approval exactly except for the quantity, which may be the same or less.⁠^45,46 The codes, modifiers and authorization forms are the manual’s and change with it, so the clinic reads the current therapy sections before its first claim and records the manual’s page-updated date in the payer register.

Does Illinois Medicaid pay for therapy in schools?

Through School Based Health Services, local education agencies may be reimbursed for direct services, occupational therapy, physical therapy and speech-language pathology among them, delivered to Medicaid-enrolled students with documented medical necessity. Since July 1, 2021 that reaches all covered services to all Medicaid-enrolled students, not only those in an IEP.⁠^47,48 A school’s billing is the district’s, under its own program; an outpatient clinic’s claim for the same child is a separate matter with its own eligibility and authorization.

What are Illinois’s telehealth rules for therapy?

A therapist treating a patient by video needs authority to practice where the patient is located at the time of the session, and the federal telehealth site says so plainly: licensure follows the patient’s location, and a compact privilege is one route to it.⁠¹¹ The Telehealth Act requires a health care professional treating a patient located in Illinois through telehealth to be licensed or authorized to practice in Illinois and allows telehealth to the extent of the professional’s scope of practice, consistent with the standards of care for in-person services. Its definition of a health care professional names occupational therapists, physical therapists and speech-language pathologists. The Physical Therapy Act adds that a patient receiving physical therapy by telehealth must be able to request and receive in-person care at any point.⁠^49,50,51

A compact privilege is not a national license: it is a privilege to practice in the specific member state that issued it, under that state’s licensing law, and a state that has enacted the compact may not yet be issuing privileges, which is why the table names the commission’s current status.⁠¹² Insurance Code section 356z.22 requires individual and group accident and health policies to cover clinically appropriate, medically necessary telehealth services in the same manner as other covered benefits, bars them from requiring in-person contact before a telehealth service, and requires in-network telehealth by an interactive telecommunications system to be paid at the in-person rate, a pay-parity rule that ends on January 1, 2028 except for mental health and substance use disorder services.⁠⁵²

Which business steps are specific to Illinois?

The entity is registered with the Illinois Secretary of State, and the choice of entity is shaped by the state’s rule on who may own a therapy business.⁠¹⁸ Physical therapists, occupational therapists and speech-language pathologists may each form a professional service corporation, whose shareholders, directors, officers, agents and employees other than ancillary personnel must be licensed to render its professional service, and which needs a certificate of registration from the licensing authority before it opens. The three professions may also combine in one professional corporation or professional limited liability company, each service offered only by persons licensed for it.⁠^19,20 State tax registration is with the Illinois Department of Revenue.⁠⁵³ Illinois’s Service Occupation Tax falls on the tangible personal property a business transfers incident to a sale of service, not on the service itself, and its rule places sales of personal services, where rendered as such, outside the Act’s scope.⁠^54,55 The Workers’ Compensation Act applies automatically to any business in which services are rendered to the public at large once its payroll in the preceding year exceeded $1,000, and a covered employer either qualifies with the Commission as a self-insurer or insures its entire liability with an authorized insurance carrier.⁠⁵⁶ A city or county business license is a local question, answered by the city hall of the clinic’s address. The startup-costs guide carries the budget worksheet these registrations go into.

What record and privacy rules apply in Illinois?

Illinois Medicaid’s general provider handbook requires enrolled providers to keep business and professional records at least six years from the date of service, or longer where another state law requires, and until any audit opened within that period is completed and every exception resolved.⁠^16,17 Two federal periods sit beside it and are often confused with it: Medicare requires 7 years for documentation of orders, certifications, referrals and payment requests, and HIPAA requires 6 years for its own compliance documentation, and neither sets the retention period for the clinical chart.⁠^57,58

The Medical Patient Rights Act establishes each patient’s right to privacy and confidentiality of records except as otherwise provided by law, alongside the rights to information about the patient’s condition and proposed treatment and to refuse treatment as the law permits, a rule that sits beside HIPAA.⁠⁵⁹ The Personal Information Protection Act requires a data collector that owns or licenses an Illinois resident’s personal information to notify the resident of a breach in the most expedient time possible and without unreasonable delay. A HIPAA covered entity in compliance with HIPAA and HITECH is deemed compliant if it also notifies the Attorney General within 5 business days of notifying the Secretary of Health and Human Services.⁠^60,61 The Abused and Neglected Child Reporting Act requires medical personnel, naming physical therapists, physical therapy assistants, occupational therapists, occupational therapy assistants and personnel engaged in the examination, care and treatment of persons, as well as school personnel and early intervention providers, to report immediately to the Department of Children and Family Services when they have reasonable cause to believe a child known to them professionally may be abused or neglected.⁠⁶²

Which Illinois rules shape a pediatric clinic?

Early Intervention serves Illinois families with children up to age 3 who have a disability or developmental delay or are substantially at risk of one, and since July 1, 2026 the Department of Early Childhood is its lead agency. Anyone can refer a child for a free screening through one of the 25 regional Child and Family Connections offices.⁠^21,22,23 A child who turns three moves from early intervention to the school district’s evaluation, and a private clinic’s services run beside both systems rather than inside them. Insurance Code section 356z.14 requires group and individual accident and health policies and managed care plans to cover the diagnosis and treatment of autism spectrum disorders for individuals under 21, treatment that includes speech, occupational and physical therapy for self care and feeding, language, cognition, motor planning and sensory processing. The statute sets a maximum benefit of $36,000 a year, adjusted annually for inflation by the Director of Insurance, with no limit on the number of visits.⁠⁶³ The autism insurance mandates guide covers how such a mandate meets a plan’s own terms. The University of Illinois Chicago’s Division of Specialized Care for Children enrolls children with eligible chronic health conditions in its Core Program, which builds a personalized care plan and can also support needs such as therapy, specialized equipment and transportation to medical appointments.⁠⁶⁴

Which Illinois rules shape an adult clinic?

Medicare claims from Illinois go to National Government Services, Inc., the Medicare Administrative Contractor for Jurisdiction 6, Parts A and B (Illinois, Minnesota and Wisconsin), whose local coverage articles for therapy are the ones an Illinois clinic reads.⁠⁶⁵ Illinois Medicaid’s adult therapy rules are in the Medicaid section above. The Illinois Workers’ Compensation Commission’s medical fee schedule, adjusted every January 1 by the change in the Consumer Price Index, sets payment for treatment of injured workers. Physical medicine services given in a hospital and billed under the hospital’s tax ID fall under its Hospital Outpatient fee schedule.⁠⁶⁶

Which associations and directory pages serve Illinois?

The state chapters are the Illinois Physical Therapy Association for physical therapy, the Illinois Occupational Therapy Association for occupational therapy and the Illinois Speech-Language-Hearing Association for speech-language pathology.⁠^67,68,69 On DrSensory, families browse Illinois clinics by discipline on the occupational therapy, physical therapy and speech therapy pages for the state, which the directory builds from the clinic addresses it holds; a clinic appears on the pages of its own address.⁠⁷⁰

Which Illinois cities have DrSensory city pages?

Beyond its three Illinois pages, the directory publishes city pages for 3 Illinois cities, 9 pages across the three disciplines, each listing the clinics whose address is in that city; a clinic appears on the city page of its address without any action of its own, and a city or discipline without a page is reached through the state page.⁠⁷⁰

How many Illinois PT, OT and SLP clinics does DrSensory list?

DrSensory lists 94 PT, OT and SLP clinics in Illinois, on its occupational therapy, physical therapy and speech therapy pages for the state.⁠⁷⁰

Where does each requirement come from, and what does the clinic do?

Which templates does an Illinois launch need?

How might two Illinois clinics plan a launch?

Sources

1. Illinois. Illinois Department of Financial and Professional Regulation, Physical Therapy. Checked October 30, 2026.
2. Illinois General Assembly. 225 ILCS 90/1.2, Physical therapy services. Checked October 30, 2026.
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   “(a) A physical therapist may provide physical therapy services to a patient with or without a referral from a health care professional. (b) A physical therapist providing services without a referral from a health care professional must notify the patient’s treating health care professional within 5 business days after the patient’s first visit that the patient is receiving physical therapy. ... (c) A physical therapist shall refer a patient to the patient’s treating health care professional of record or, in the case where there is no health care professional of record, to a health care professional of the patient’s choice, if: (1) the patient does not demonstrate measurable or functional improvement after 10 visits or 15 business days, whichever occurs first, and continued improvement thereafter; ... (d) Wound debridement services may only be provided by a physical therapist with written authorization from a health care professional.”
3. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topic J-211, Prior Approval Process. Checked October 30, 2026.
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   “Public Act 098- 0651(pdf) later removed those visit caps for adults but required prior approval for all therapy services, prompting the Department to implement the addition of prior approval for physical and occupational therapy for children through age 20 effective November 16, 2015. Speech therapy prior approval for children will be implemented at a later date. ... Prior approval by the Department is required for the provision of all therapy services except when the service is: • Approved by Medicare • Reimbursed by an MCO or MCCN as indicated above in this topic • Speech therapy rendered to a child through age 20 • A therapy evaluation visit ...”
4. Illinois Department of Healthcare and Family Services. Handbook for Providers of Healthy Kids Services, Chapter HK-200 (issued March 2017), Topic HK-200.1, Early and Periodic Screening, Diagnosis and Treatment (EPSDT). Checked October 30, 2026.
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   “Children enrolled in HFS’ All Kids Program are entitled to preventive health screening services under the EPSDT benefit, without patient co-payments. ... It is a comprehensive child health program that provides initial and periodic examinations and medically necessary follow up care. EPSDT is not a separate program but simply a way to refer to the comprehensive benefit package to which Medicaid participants are entitled.”
5. Illinois. Illinois Department of Financial and Professional Regulation, Occupational Therapy. Checked October 30, 2026.
6. Illinois. Illinois Department of Financial and Professional Regulation, Speech-Language Pathology and Audiology. Checked October 30, 2026.
7. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topic J-203.1, Practitioner Orders. Checked October 30, 2026.
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   “A written recommendation (order) signed and dated by the patient’s practitioner (i.e., M.D., D.O., APN, Physician Assistant and a D.C. only when working within the scope of practice) is required for the provision of therapy services.”
8. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1340.85, Physical Therapy Services. Checked October 30, 2026.
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   “A physical therapist providing services without a referral from a health care professional must notify the patient’s treating health care professional within 5 business days after the patient’s first visit that the patient is receiving physical therapy pursuant to Section 1.2 of the Act. In the case where there is no treating health care professional, the physical therapist should offer to notify a health care professional of the patient’s choice.”
9. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topics J-203.2 and J-211. Checked October 30, 2026.
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   “Covered Occupational Therapy services include medically necessary evaluations and treatment by a licensed Occupational Therapist when: a) services are required because an illness, disability or infirmity limits functional performance; and b) Occupational Therapy services will improve functional skills performance. ... The Department has required prior approval for adult therapy services since July 1, 2012, in order to comply with the requirements of Public Act 097-0689 ... which limited adult therapy services to 20 visits per year, per discipline. Public Act 098- 0651(pdf) later removed those visit caps for adults but required prior approval for all therapy services ...”
10. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topic J-204, Non-Covered Services. Checked October 30, 2026.
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    “Services provided for the general good and welfare of participants, such as fitness exercises and activities to provide diversion or general motivation, and maintenance therapy to maintain the current level of function, are not covered.”
11. U.S. Department of Health and Human Services. Getting started with licensure (Telehealth.HHS.gov, last updated February 21, 2024). Checked October 26, 2026.
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    “Health professionals must meet the licensure requirements of the state where they are located and be licensed or legally permitted to practice in the state where the patient is located”. Its companion page, Licensing across state lines (last updated April 30, 2025): “The ability to deliver health care services across state lines varies based on state regulations”; “Prior to an appointment, providers should verify patient location and obtain consent”; “Compacts allow participating health care providers to practice in participating states”.
12. PT Compact Commission. PT Compact Map. “Introduced Legislation (2) Illinois Massachusetts ... PT Compact Legislation Introduced but Not Enacted Yet ...” Checked October 30, 2026.
13. Occupational Therapy Compact Commission. State Commissioners. Checked October 30, 2026.
14. Audiology and Speech-Language Pathology Interstate Compact Commission. Delegate Information. Checked October 30, 2026.
15. Code of Federal Regulations. 42 CFR 424.24, Requirements for medical and other health services furnished by providers under Medicare Part B (eCFR, up to date as of October 22, 2026; paragraph (c), outpatient physical therapy, occupational therapy and speech-language pathology services). Checked October 26, 2026.
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    “The individual needs, or needed, physical therapy, occupational therapy, or speech-language pathology services.”; “The services were furnished while the individual was under the care of a physician, nurse practitioner, clinical nurse specialist, or physician assistant.”; “The initial certification must be obtained as soon as possible after the plan is established.”; “Recertification is required at least every 90 days.”; “When it is recertified, the plan or other documentation in the patient’s record must indicate the continuing need for physical therapy, occupational therapy or speech-language pathology services.”; “the therapist has documented evidence that the plan of treatment has been delivered to the physician, NP, PA, or CNS within 30 days of completion of the initial evaluation, the certification does not need to be signed by a physician, NP, CNS, or PA who has knowledge of the case.”; “No references to an order or referral in this subsection shall be construed to require an order or referral for outpatient physical therapy, occupational therapy, or speech-language pathology services.”.
16. Illinois Department of Healthcare and Family Services. Handbook for Providers of Medical Services, Chapter 100, General Policy and Procedures (issued September 2017), Topic 110.2, Retention of Records. Checked October 30, 2026.
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    “Business and professional records must be maintained for a period of not less than six (6) years from the date of service or as otherwise provided by applicable state law, whichever period is longer, except that: • If an audit is initiated within the required retention period, the records must be retained until the audit is completed and every exception resolved.”
17. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topic J-205, Record Requirements. Checked October 30, 2026.
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    “For therapy services, the basic record must include: • Current practitioner’s order signed by a physician (M.D., D.O. or D.C.), advanced practice nurse, or physician assistant • Clinical diagnoses, if not included in the practitioner’s order • Participant’s name, recipient identification number (RIN) and address • Initial assessment and treatment plan • Progress reports • Approved prior authorization requests, if applicable ...”
18. Illinois Secretary of State. Business Services. Checked October 30, 2026.
19. Illinois General Assembly. 805 ILCS 10/3.4, 10/3.6 and 10/12(a), Professional Service Corporation Act. Checked October 30, 2026.
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    “"Professional Corporation" means: (1) a corporation organized under this Act; ... that is organized solely for the purpose of rendering one category of professional service or related professional services and which has as its shareholders, directors, officers, agents and employees (other than ancillary personnel) only individuals who are duly licensed by this State ... to render that particular category of professional service or related professional services ... (d) the practice of occupational therapy by persons licensed under the Illinois Occupational Therapy Practice Act, (e) the practice of physical therapy by persons licensed under the Illinois Physical Therapy Act, (f) the practice of speech-language therapy by persons licensed under the Illinois Speech-Language Pathology and Audiology Practice Act, ... No corporation shall open, operate or maintain an establishment for any of the purposes for which a corporation may be organized under this Act without a certificate of registration from the regulating authority authorized by law to license individuals to engage in the profession or related professions concerned.”
20. Illinois General Assembly. 805 ILCS 185/13(b), Professional Limited Liability Company Act. Checked October 30, 2026.
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    “(b) Notwithstanding any provision of this Section, any of the following professional services may be combined and offered within a single professional limited liability company provided that each professional service is offered only by persons licensed to provide that professional service and all managers and members are licensed in at least one of the professional services offered by the professional limited liability company: ... the practice of occupational therapy by persons licensed under the Illinois Occupational Therapy Practice Act, the practice of physical therapy by persons licensed under the Illinois Physical Therapy Act ...”
21. Illinois Department of Early Childhood. Early Intervention Services. Checked October 30, 2026.
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    “Early Intervention (EI) is a federal program for families with children up to age 3, with a disability, and/or a developmental delay or substantially at risk of a developmental delay. ... Anyone can refer a child for free EI screening. To get started, you can go directly to one of the 25 regional Child and Family Connections (CFC) offices to schedule a free evaluation. You can also talk to a pediatrician or doctor for a referral.”
22. Illinois Department of Early Childhood. Welcome - Illinois Department of Early Childhood. Checked October 30, 2026.
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    “Starting July 1, 2026, the Illinois Department of Early Childhood officially became the lead agency for Child Care Licensing, the Head Start State Collaboration Office Grant, Home Visiting, Early Intervention, the Child Care Assistance Program, Early Childhood Block Grant, and a range of other early childhood support to families, providers and educators.”
23. Illinois Department of Early Childhood. Early Intervention Services. “Find the Child and Family Connections (CFC) office that serves your county above, or call 1-800-843-6154 (Voice/TTY).” Checked October 30, 2026.
24. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1340.55, Renewals. Checked October 30, 2026.
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    “Every physical therapy license issued under the Act shall expire on September 30 of each even-numbered year. Every physical therapist assistant license issued under the Act shall expire on September 30 or each odd-numbered year. The holder of a license may renew the license during the month preceding the expiration date of the license by paying the required fee and completing continuing education (CE) as set forth in Section 1340.61.”
25. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1340.61, Continuing Education. Checked October 30, 2026.
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    “Every physical therapist shall complete 40 hours of CE relevant to the practice of physical therapy during each prerenewal period as a condition of renewal. Beginning with the September 2016 renewal, at least 3 hours of the 40 hours must include content related to the ethical practice of physical therapy, including jurisprudence. 2) Every physical therapist assistant shall complete 20 hours of CE relevant to the practice of physical therapy during each prerenewal period as a condition of renewal. Beginning with the September 2017 renewal, at least 3 hours of the 20 hours must include content related to the ethical practice of physical therapy, including jurisprudence. 3) A prerenewal period is the 24 months preceding September 30 in the year of the renewal. ... 6) A renewal applicant is not required to comply with CE requirements for the first renewal following the original issuance of the license.”
26. Illinois General Assembly. 225 ILCS 90/1(9), Illinois Physical Therapy Act. Checked October 30, 2026.
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    “"Physical therapist assistant" means a person licensed to assist a physical therapist and who has met all requirements as provided in this Act and who works under the supervision of a licensed physical therapist to assist in implementing the physical therapy treatment program as established by the licensed physical therapist. The patient care activities provided by the physical therapist assistant shall not include the interpretation of referrals, evaluation procedures, or the planning or major modification of patient programs.”
27. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1315.140, Renewal. “Every license issued under the Act shall expire on December 31 of each odd numbered year. The holder of the license may renew such license during the month preceding the expiration date by paying the required fee.” Checked October 30, 2026.
28. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1315.145, Continuing Education. Checked October 30, 2026.
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    “Every occupational therapist and occupational therapy assistant shall complete 24 contact hours of CE relevant to the practice of occupational therapy during each prerenewal period as a condition of renewal. A prerenewal period is the 24 months preceding December 31 in the year of the renewal. ... 2) In each renewal period, one contact hour shall include a course in ethics. 3) In each renewal period, one contact hour shall include a course in sexual harassment prevention training ... 4) In each renewal period, one contact hour shall include a course on implicit bias awareness training ... 5) In each renewal period, one contact hour shall include a course on dementia recognition training, which shall only apply to licensees who provide health care services to, and have direct patient interactions with, adult populations age 26 or older in the practice of the licensee’s profession.”
29. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1315.163, Supervision of an Occupational Therapy Assistant. Checked October 30, 2026.
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    “A certified occupational therapy assistant shall practice only under the supervision of a registered occupational therapist. ... The supervisors shall be responsible for the standard of work performed by the assistant and shall have knowledge of the patients/clients and the problems being discussed. Co-signature does not reflect supervision. ... The occupational therapy assistant who has less than one year of work experience or who is entering new practice environments or developing new skills shall receive a minimum of 5% on-site face-to-face supervision from a registered occupational therapist per month. ... The occupational therapy assistant with more than one year of experience in his/her current practice shall have a minimum of 5% direct supervision from a registered occupational therapist per month. The 5% direct supervision shall consist of 2% direct, face-to-face collaboration.”
30. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1465.70, Renewal. “Every license issued under the Act shall expire on October 31 of odd numbered years. The holder of a license may renew the license during the month preceding the expiration date by paying the required fee.” Checked October 30, 2026.
31. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1465.85, Continuing Education. Checked October 30, 2026.
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    “In order to renew a speech-language pathology or audiology license, a licensee will be required to complete 20 hours of CE in accordance with this Section. In order to renew a speech-language pathology assistant license, a licensee will be required to complete 10 hours of CE in accordance with this Section. 2) A prerenewal period is the 24 months preceding October 31 of each odd-numbered year. ... 6) A speech-language pathologist must provide proof that at least one clock hour of ethics training was completed during the 2-year licensing cycle for which he or she is currently licensed.”
32. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 68 Ill. Adm. Code 1465.35(c), Supervision. Checked October 30, 2026.
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    “Practice only under the supervision of a licensed speech-language pathologist who has at least 2 years’ experience in addition to the supervised professional experience required under Section 8(f) of the Act. A speech-language pathologist who supervises a speech-language pathology assistant must have completed at least 6 clock hours of training in supervision related to speech-language pathology ... Be under the direct supervision of a licensed speech-language pathologist at least 30% of the speech-language pathology assistant’s actual patient or client contact time per patient or client on a weekly basis during the first 90 days of initial employment as a speech-language pathology assistant. Thereafter, a speech-language pathology assistant must be under the direct supervision of a licensed speech-language pathologist at least 20% of the speech-language pathology assistant’s actual patient or client contact time per patient or client on a weekly basis. ... A full-time speech-language pathologist may supervise no more than 2 speech-language pathology assistants. A speech-language pathologist who does not work full-time may supervise no more than one speech-language pathology assistant.”
33. Illinois General Assembly. 225 ILCS 75/3.1, Referrals (text before amendment by P.A. 104-591). Checked October 30, 2026.
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    “(a) A licensed occupational therapist or licensed occupational therapy assistant may evaluate, initiate, and provide occupational therapy services and consult with, educate, evaluate, and monitor services for individuals, groups, and populations concerning occupational therapy needs without a referral. (b) (Blank). (c) Referral from a physician or other health care provider is not required for evaluation or intervention for children and youths if an occupational therapist or occupational therapy assistant provides services in a school-based or educational environment, including the child’s home. (d) An occupational therapist shall refer a patient to the patient’s treating health care professional of record, or to a health care professional of the patient’s choosing if there is no health care professional of record, if: (1) the patient does not demonstrate measurable or functional improvement after 10 visits or 15 business days, whichever occurs first, and continued improvement thereafter ...”
34. Illinois General Assembly. 225 ILCS 75/3.1, Referrals (text after amendment by P.A. 104-591, effective January 1, 2027). Checked October 30, 2026.
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    “(Text of Section after amendment by P.A. 104-591 ) ... (a) A licensed occupational therapist or licensed occupational therapy assistant may, within the licensee’s scope of practice, provide occupational therapy services for individuals, groups, and populations concerning occupational therapy needs without a referral. (b) (Blank). (b-5) A referral is not required for the purpose of providing consultation, habilitation, screening, education, wellness, prevention, environmental assessments, and work-related ergonomic services. ... (1) the patient does not demonstrate measurable or functional improvement after 10 visits and continued improvement thereafter; ... (Source: P.A. 103-251, eff. 1-1-24; 104-591, eff. 1-1-27.)”
35. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topic J-203.1, Practitioner Orders. Checked October 30, 2026.
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    “A written recommendation (order) signed and dated by the patient’s practitioner (i.e., M.D., D.O., APN, Physician Assistant and a D.C. only when working within the scope of practice) is required for the provision of therapy services.”
36. Illinois General Assembly. 225 ILCS 110/3(h) and 110/7(a). Checked October 30, 2026.
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    “"The practice of speech-language pathology" is the application of nonmedical methods and procedures for the identification, measurement, testing, appraisal, prediction, habilitation, rehabilitation, and modification related to communication development, and disorders or disabilities of speech, language, voice, swallowing, and other speech, language and voice related disorders. ... (a) Except as provided in subsection (b), on or after June 1, 1989, no person shall practice speech-language pathology or audiology without first applying for and obtaining a license for such purpose from the Department.”
37. Illinois General Assembly. 225 ILCS 110/9.3(a), Requirements for the use of laryngoscopes. Checked October 30, 2026.
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    “If the patient has a voice disorder or vocal cord dysfunction, he or she must be examined by a physician who has been granted hospital privileges to perform these procedures and the speech-language pathologist must have received from that physician a written referral and direct authorization to perform the procedure. (4) If the patient has a swallowing disorder or a velopharyngeal disorder, he or she must be examined by a physician licensed to practice medicine in all its branches and the speech-language pathologist must have received from that physician a written referral and direct authorization to perform the procedure.”
38. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topic J-203.1, Practitioner Orders. Checked October 30, 2026.
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    “A written recommendation (order) signed and dated by the patient’s practitioner (i.e., M.D., D.O., APN, Physician Assistant and a D.C. only when working within the scope of practice) is required for the provision of therapy services.”
39. Illinois Department of Healthcare and Family Services. IMPACT Home. Checked October 30, 2026.
40. Medicaid.gov (Centers for Medicare & Medicaid Services). Early and Periodic Screening, Diagnostic, and Treatment (Medicaid benefit page). Checked October 26, 2026.
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    “The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid.”; “It is the responsibility of states to determine medical necessity on a case-by-case basis.”.
41. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topics J-211 and J-211.1. Checked October 30, 2026.
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    “Prior approval requests for participants in an MCO or MCCN should be directed to the individual plan. Prior approval by the Department is required for the provision of all therapy services except when the service is: • Approved by Medicare • Reimbursed by an MCO or MCCN as indicated above in this topic • Speech therapy rendered to a child through age 20 • A therapy evaluation visit ... The provider is to complete Form HFS 3701T, Therapy Prior Approval Request Form, when requesting covered services. ... Form HFS 3701T must be accompanied by a current signed and dated practitioner order for the services requested.”
42. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topic J-203.1, Practitioner Orders. “Practitioners are required to order the therapy. Orders are valid for 12 months.” Checked October 30, 2026.
43. Illinois Department of Healthcare and Family Services. Care Coordination. Checked October 30, 2026.
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    “The Department operates three distinct care coordination programs within the broader Illinois Medicaid Managed Care program: HealthChoice Illinois (HCI), YouthCare, and the Medicare Medicaid Alignment Initiative (MMAI). ... In order to participate in the statewide managed care programs, and provide services to patients enrolled in a plan, Providers are encouraged to contract with each of the qualified, experienced, and financially sound Managed Care plans. Before contracting with any plans, providers must also make sure they are enrolled in the Department’s IMPACT system.”
44. Illinois Department of Healthcare and Family Services. Therapy Fee Schedule. Checked October 30, 2026.
45. Illinois Department of Healthcare and Family Services. Handbook for Therapy Providers, Chapter J-200 Appendices, Appendix J-1, Technical Guidelines for Paper Claim Preparation, Form HFS 1443. Checked October 30, 2026.
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    “Required Proc. Code/NDC - Enter the appropriate CPT code. Required Modifiers GP - Physical Therapy GO - Occupational Therapy GN - Speech Therapy Enter any other appropriate two-byte modifier(s) for the service performed.”
46. Illinois Department of Healthcare and Family Services. Handbook for Providers of Therapy Services, Chapter J-200 (issued July 2016), Topics J-211 and J-211.1. Checked October 30, 2026.
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    “Except for quantity, a claim submitted for payment must match the prior approval exactly or the claim will be rejected. The quantity billed may be either the same as or less than the maximum quantity approved. The date of service must be within the approved prior approval date range. ... The provider is to complete Form HFS 3701T, Therapy Prior Approval Request Form, when requesting covered services.”
47. Illinois Department of Healthcare and Family Services. School Based Health Services Home. Checked October 30, 2026.
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    “In Illinois, Local Education Agencies (LEAs) may receive reimbursement for delivering direct services to Medicaid-enrolled students with documented medical necessity. Services must be covered under the Medicaid State Plan or available under the Early and Period Screening, Diagnostic, and Treatment (EPSDT) benefit, such as: ... Occupational therapy ... Physical therapy ... Speech/language pathology ...”
48. Illinois Department of Healthcare and Family Services. School Based Health Services Home. “Effective July 1, 2021, Illinois expanded reimbursement for SBHS to all covered health services provided to all Medicaid-enrolled students. Prior to this expansion, schools could only bill for services part of a student’s Individualized Education Plan (IEP).” Checked October 30, 2026.
49. Illinois General Assembly. 225 ILCS 150/10 and 150/15(a), Telehealth Act. Checked October 30, 2026.
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    “A health care professional treating a patient located in this State through telehealth services must be licensed or authorized to practice in Illinois. ... A health care professional may engage in the practice of telehealth services in Illinois to the extent of his or her scope of practice as established in his or her respective licensing Act consistent with the standards of care for in-person services. This Act shall not be construed to alter the scope of practice of any health care professional or authorize the delivery of health care services in a setting or in a manner not otherwise authorized by the laws of this State.”
50. Illinois General Assembly. 225 ILCS 150/5, Definitions. “"Health care professional" includes, but is not limited to, physicians, physician assistants, optometrists, advanced practice registered nurses, clinical psychologists licensed in Illinois, prescribing psychologists licensed in Illinois, dentists, occupational therapists, pharmacists, physical therapists, clinical social workers, speech-language pathologists, audiologists ...” Checked October 30, 2026.
51. Illinois General Assembly. 225 ILCS 90/1.3(b), Telehealth services. Checked October 30, 2026.
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    “(1) Physical therapists may use telehealth to perform an initial physical therapy evaluation if one of the following criteria is met: (i) the patient has a referral or diagnosis from a health care professional; (ii) the patient has an established relationship with the physical therapist; or (iii) the physical therapist has the capacity to perform or facilitate a referral for an in-person, hands-on examination or re-examination by a physical therapist at any time throughout the course of the patient’s care, as needed. (2) A physical therapist or a physical therapist assistant may require the patient to undergo an in-person visit instead of providing telehealth services. (3) A patient receiving physical therapy via telehealth must be able to request and receive in-person care at any point during their treatment.”
52. Illinois General Assembly. 215 ILCS 5/356z.22, Coverage for telehealth services (Illinois Insurance Code). Checked October 30, 2026.
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    “An individual or group policy of accident or health insurance that is amended, delivered, issued, or renewed on or after the effective date of this amendatory Act of the 102nd General Assembly shall cover telehealth services, e-visits, and virtual check-ins rendered by a health care professional when clinically appropriate and medically necessary to insureds, enrollees, and members in the same manner as any other benefits covered under the policy. ... (A) require that in-person contact occur between a health care professional and a patient before the provision of a telehealth service; ... shall reimburse an in-network health care professional or facility, including a health care professional or facility in a tiered network, for telehealth services provided through an interactive telecommunications system on the same basis, in the same manner, and at the same reimbursement rate that would apply to the services if the services had been delivered via an in-person encounter by an in-network or tiered network health care professional or facility. ... This subsection is inoperative on and after January 1, 2028, except that this subsection is operative after that date with respect to mental health and substance use disorder telehealth services.”
53. Illinois Department of Revenue. Business Registration. Checked October 30, 2026.
54. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 86 Ill. Adm. Code 140.101, Basis and Rate of the Service Occupation Tax. Checked October 30, 2026.
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    “The Service Occupation Tax Act (the Act or the SOTA) [35 ILCS 115] imposes a tax upon persons engaged in this State in the business of making sales of service, based on tangible personal property transferred incident to sales of service. These persons are referred to in this Part as servicemen.”
55. Illinois General Assembly, Joint Committee on Administrative Rules (Illinois Administrative Code). 86 Ill. Adm. Code 140.125(c), Examples of Nontaxability. “The tax does not apply to: ... sales or transfers of personal services, where rendered as such. These types of sales are outside the scope of the Service Occupation Tax Act ...” Checked October 30, 2026.
56. Illinois General Assembly. 820 ILCS 305/3 and 305/4(a), Workers’ Compensation Act. Checked October 30, 2026.
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    “The provisions of this Act hereinafter following shall apply automatically and without election to the State, county, city, town, township, incorporated village or school district, body politic or municipal corporation, and to all employers and all their employees, engaged in any department of the following enterprises or businesses which are declared to be extra hazardous, namely: ... 17. (a) Any business or enterprise in which goods, wares or merchandise are sold or in which services are rendered to the public at large, provided that this paragraph shall not apply to such business or enterprise unless the annual payroll during the year next preceding the date of injury shall be in excess of $1,000. ... (3) Insure his entire liability to pay such compensation in some insurance carrier authorized, licensed, or permitted to do such insurance business in this State.”
57. Code of Federal Regulations. 42 CFR 424.516, Additional provider and supplier requirements for enrolling and maintaining active enrollment status in the Medicare program (eCFR, up to date as of October 22, 2026; paragraph (f), Maintaining and providing access to documentation). Checked October 26, 2026.
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    “A provider or a supplier that furnishes covered ordered, certified, referred, or prescribed Part A or B services, items or drugs is required to—”; “Maintain documentation (as described in paragraph (f)(1)(ii) of this section) for 7 years from the date of service; and”; “Upon the request of CMS or a Medicare contractor, to provide access to that documentation”; “The documentation includes written and electronic documents (including the NPI of the physician or, when permitted, other eligible professional who ordered, certified, referred, or prescribed the Part A or B service, item, or drug) relating to written orders, certifications, referrals, prescriptions, and requests for payments for Part A or B services, items or drugs.”.
58. Code of Federal Regulations. 45 CFR 164.316, Policies and procedures and documentation requirements (eCFR, up to date as of October 22, 2026; HIPAA Security Rule; paragraph (b)). Checked October 26, 2026.
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    “Maintain the policies and procedures implemented to comply with this subpart in written (which may be electronic) form; and”; “If an action, activity or assessment is required by this subpart to be documented, maintain a written (which may be electronic) record of the action, activity, or assessment.”; “Retain the documentation required by paragraph (b)(1) of this section for 6 years from the date of its creation or the date when it last was in effect, whichever is later.”.
59. Illinois General Assembly. 410 ILCS 50/3(a), Medical Patient Rights Act. Checked October 30, 2026.
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    “The following rights are hereby established: (a) The right of each patient to care consistent with sound nursing and medical practices, to be informed of the name of the physician responsible for coordinating his or her care, to receive information concerning his or her condition and proposed treatment, to refuse any treatment to the extent permitted by law, and to privacy and confidentiality of records except as otherwise provided by law.”
60. Illinois General Assembly. 815 ILCS 530/10(a), Personal Information Protection Act. Checked October 30, 2026.
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    “Any data collector that owns or licenses personal information concerning an Illinois resident shall notify the resident at no charge that there has been a breach of the security of the system data following discovery or notification of the breach. The disclosure notification shall be made in the most expedient time possible and without unreasonable delay, consistent with any measures necessary to determine the scope of the breach and restore the reasonable integrity, security, and confidentiality of the data system.”
61. Illinois General Assembly. 815 ILCS 530/50, Personal Information Protection Act. Checked October 30, 2026.
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    “Any covered entity or business associate that is subject to and in compliance with the privacy and security standards for the protection of electronic health information established pursuant to the federal Health Insurance Portability and Accountability Act of 1996 and the Health Information Technology for Economic and Clinical Health Act shall be deemed to be in compliance with the provisions of this Act, provided that any covered entity or business associate required to provide notification of a breach to the Secretary of Health and Human Services pursuant to the Health Information Technology for Economic and Clinical Health Act also provides such notification to the Attorney General within 5 business days of notifying the Secretary.”
62. Illinois General Assembly. 325 ILCS 5/4(a), Abused and Neglected Child Reporting Act. Checked October 30, 2026.
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    “(a) The following persons are required to immediately report to the Department when they have reasonable cause to believe that a child known to them in their professional or official capacities may be an abused child or a neglected child: (1) Medical personnel, including any: physician licensed to practice medicine in any of its branches (medical doctor or doctor of osteopathy); resident; intern; medical administrator or personnel engaged in the examination, care, and treatment of persons; ... physical therapist; physical therapy assistant; occupational therapist; occupational therapy assistant; ... (4) Education personnel, including any: school personnel (including administrators and certified and non-certified school employees); ... (6) Child care personnel, including any: early intervention provider as defined in the Early Intervention Services System Act ...”
63. Illinois General Assembly. 215 ILCS 5/356z.14, Autism spectrum disorders (Illinois Insurance Code). Checked October 30, 2026.
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    “(a) A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after December 12, 2008 (the effective date of Public Act 95-1005) must provide individuals under 21 years of age coverage for the diagnosis of autism spectrum disorders and for the treatment of autism spectrum disorders to the extent that the diagnosis and treatment of autism spectrum disorders are not already covered by the policy of accident and health insurance or managed care plan. (b) Coverage provided under this Section shall be subject to a maximum benefit of $36,000 per year but shall not be subject to any limits on the number of visits to a service provider. The Director of Insurance shall, on an annual basis, adjust the maximum benefit for inflation using the Medical Care Component of the United States Department of Labor Consumer Price Index for All Urban Consumers. ... (4) Therapeutic care, including behavioral, speech, occupational, and physical therapies that provide treatment in the following areas: (i) self care and feeding, (ii) pragmatic, receptive, and expressive language, (iii) cognitive functioning, (iv) applied behavior analysis, intervention, and modification, (v) motor planning, and (vi) sensory processing.”
64. University of Illinois Chicago, Division of Specialized Care for Children. Core Program. Checked October 30, 2026.
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    “Children who have eligible chronic health issues are enrolled in the Core Program. Core Program services include developing a personalized care plan and providing support, resources and guidance to families. The program can also support needs such as therapy, specialized equipment and transportation related to medical appointments and treatment.”
65. Centers for Medicare & Medicaid Services. Who are the MACs: A/B MAC Jurisdiction 6 (J6). “Contract Awardee: National Government Services, Inc., contract number 75FCMC20C0026 ... J6 processes FFS Medicare Part A and Part B claims for Illinois, Minnesota, and Wisconsin ...” Checked October 30, 2026.
66. Illinois Workers’ Compensation Commission. Medical Fee Schedule - Resources. Checked October 30, 2026.
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    “Physical therapy is unique. If physical medicine services are provided in a hospital setting and billed under the hospital’s tax ID number, they would be subject to the Hospital Outpatient fee schedule. ... According to Section 8.2(a) of the Act, on January 1 of each year the IWCC adjusts all the fees by the percentage change in the Consumer Price Index-All Urban Consumers, All Items (1982-84=100) for the 12-month period ending August 31 of the previous year.”
67. the Illinois Physical Therapy Association. the Illinois Physical Therapy Association (the state association's site). Checked October 30, 2026.
68. the Illinois Occupational Therapy Association. the Illinois Occupational Therapy Association (the state association's site). Checked October 30, 2026.
69. the Illinois Speech-Language-Hearing Association. the Illinois Speech-Language-Hearing Association (the state association's site). Checked October 30, 2026.
70. DrSensory. Occupational therapy clinics in Illinois, with the physical therapy and speech therapy pages for the state (the directory's state pages, built from the addresses it holds). Checked October 30, 2026.
71. DrSensory. Clinic Directory Pricing. “Claiming your listing is free. The subscription is $349.99 a year or $29.99 a month for your first location, and $99.99 a year or $9.99 a month for each additional location, not per therapist.” Checked October 30, 2026.

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 clinic in Illinois, not legal, compliance, billing or financial advice. Rules change; the clinic confirms each with its source before acting on it.