Massachusetts PT, OT and SLP guide

For OT, PT and SLP clinics in Massachusetts: two state boards license the disciplines; the licensing law and the board’s rules give the physical therapist the evaluation, the PT diagnosis and the plan of care; MassHealth 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 Massachusetts?

Two state boards license the three disciplines in Massachusetts, and each publishes its own licensing law, rules, renewal cycle and continuing-education requirement.⁠^1,5,6 A clinic that employs more than one discipline keeps three registers, not one.

Physical therapists, occupational therapists and their assistants answer to the Board of Allied Health Professions.⁠^{1,5,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40} Speech-language pathologists answer to the Board of Registration for Speech-Language Pathology and Audiology.⁠^{6,41,42,43,44,45,46} One board, the Board of Allied Health Professions in the Department of Public Health’s Bureau of Health Professions Licensure, licenses physical therapists and assistants and occupational therapists and assistants, along with athletic trainers.⁠^{1,24,25,26,27,28,29,30,31,32,33} Massachusetts also licenses the place where physical therapy is delivered: a physical therapy clinic needs a Physical Therapy Facility license from the board before it provides physical therapy and renews it every year. A place where all the physical therapy is provided by one primary physical therapist who owns at least 51 percent of the business is exempt, as are a hospital, clinic or home health agency licensed by the Department of Public Health.⁠^{1,24,25,26,27,28,29,30,31,32,33} Speech-language pathologists and assistants are licensed by a separate board, the Board of Registration for Speech-Language Pathology and Audiology, also in the Bureau of Health Professions Licensure.⁠^{6,41,42,43,44,45,46} 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 a Massachusetts license renewal require?

Each board sets its own cycle and hours, 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 board’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 a Massachusetts 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, the licensing law defines physical therapy as evaluation, treatment and instruction related to neuromuscular, musculoskeletal, cardiovascular and respiratory functions, with evaluation that includes performing and interpreting tests as an aid to the diagnosis or planning of treatment programs, and the board’s rules make the physical therapist solely responsible for the initial clinical examination, the PT diagnosis and prognosis and the plan of care.⁠^2,7,8,9 For occupational therapy, the licensing law defines occupational therapy to include administering and interpreting tests for treatment planning and developing daily living, perceptual motor, sensory integrative and play skills, and the board’s rules have the occupational therapist initiate and direct the evaluation and take primary responsibility for the intervention plan.⁠^47,48,49 For speech-language pathology, the licensure act defines speech-language pathology as the application of principles, methods and procedures of measurement, prediction, evaluation, testing, counseling, consultation and remediation related to the development and disorders of speech and language.⁠^50,51 MassHealth, as a payer, pays only for the treatments and evaluations for which the therapist has a written prescription from the member’s physician, nurse practitioner or physician assistant, and pays for continuing therapy only when that provider signs the prescription or plan of care every 60 days.⁠⁹

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.⁠¹⁶ MassHealth’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 MassHealth pay for pediatric and adult therapy?

MassHealth is Massachusetts’s Medicaid program, run by the Executive Office of Health and Human Services (EOHHS), and a clinic enrolls through its provider enrollment route before it bills.⁠⁵² 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.⁠⁵³ For EPSDT-eligible members, MassHealth pays for all medically necessary therapy services without regard to the therapist regulations’ service limitations, with prior authorization, and a therapist may request prior authorization for any medically necessary service reimbursable under the federal Medicaid Act for a MassHealth Standard or CommonHealth member younger than 21, even one Subchapter 6 does not list as covered.⁠^3,4

MassHealth pays therapists for individual treatment, initial evaluations and reevaluations, co-treatment and group therapy, subject to its regulations’ conditions and limits, and covers therapist services only for eligible members as each coverage type allows.⁠^10,11 MassHealth requires prior authorization before it pays for more than 20 occupational therapy or 20 physical therapy visits, or more than 35 speech and language therapy visits, for a member in a 12-month period (group visits count, evaluations do not), and for more than two evaluations in 12 months. For members in capitated programs, the therapist follows the plan’s own prior authorization procedures.⁠^54,55,56 MassHealth members choose among three types of health plans: Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs) and the Primary Care Clinician (PCC) plan. Members under 65 without other insurance who live in the community and are in MassHealth Standard, CommonHealth, CarePlus or Family Assistance enroll in a plan.⁠^57,58,59 The fee schedule is published by the agency, and a clinic reads the current file rather than a remembered rate.⁠⁶⁰

How does MassHealth want OT, PT and SLP claims coded?

Services by supervised PTAs, OTAs and SLPAs are billed under the MassHealth provider ID of the supervising enrolled therapist. MassHealth pays for no more than one individual treatment and one group session per member per day, and for physical and occupational therapy the maximum is four treatment units per visit unless otherwise indicated. The GP, GO and GN modifiers indicate services under an outpatient physical therapy, occupational therapy or speech-language pathology plan of care.⁠^{61,62,63,64,65} 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 MassHealth pay for therapy in schools?

Through the School-Based Medicaid Program, local education agencies can receive federal dollars to offset the costs of certain Medicaid-covered direct services in a school setting, occupational therapy, physical therapy and speech therapy among them.⁠⁶⁶ 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.

Does MassHealth cover therapy by telehealth?

The therapist manual lists therapy codes with the GT modifier for services conducted via interactive audio and video telecommunication systems, and telehealth codes may only be used when clinically appropriate.⁠⁶⁷ The telehealth section below covers the state’s own rules for the session itself.

What are Massachusetts’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.⁠¹² The speech-language pathology board’s telepractice policy requires anyone serving clients who reside or are located in Massachusetts by telepractice to hold a Massachusetts license, requires telepractice to equal the quality of in-person services, and requires 10 hours of telepractice training first. Massachusetts insurance law requires health care services provided via telehealth to conform to the standards of care of the provider’s profession and to standards for informed consent.⁠^68,69,70

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.⁠¹³ Section 47MM requires insurance policies to cover health care services delivered via telehealth by a contracted provider when the services are covered in person and may appropriately be provided by telehealth, and limits telehealth deductibles, copayments and coinsurance to the in-person amounts. Its payment-parity rule names only behavioral health services.⁠^71,72

Which business steps are specific to Massachusetts?

The entity is registered with the Secretary of the Commonwealth’s Corporations Division, and the choice of entity is shaped by the state’s rule on who may own a therapy business.⁠²⁰ Massachusetts’s professional corporation law names registered or licensed physical therapists among the professions whose services a professional corporation renders, and extends it to any other service that may be rendered only under a Massachusetts license if the regulating board permits incorporation, or the licensee elects it and neither law nor the board’s regulations prohibit it.⁠²¹ Before a Massachusetts clinic provides physical therapy, it needs a Physical Therapy Facility license from the Board of Allied Health Professions, renewed every year, unless one of the exemptions in the licensing section applies. State tax registration is with the Department of Revenue, through MassTaxConnect.⁠⁷³ The Department of Revenue lists personal or professional services, legal and medical services among them, as generally exempt from the sales and use tax. Items sold along with services are taxable and must be itemized separately on the bill, and some health care items are exempt only when a registered physician prescribes them.⁠^74,75 Massachusetts requires every employer to provide workers’ compensation for its employees by insurance or by a license as a self-insurer. The Department of Industrial Accidents says the requirement applies no matter the number of hours worked or the number of employees, while LLC members, LLP partners and sole proprietors need not insure themselves.⁠^76,77 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 Massachusetts?

A licensed Physical Therapy Facility must keep patient records at least seven years from the last patient encounter for patients who were two or older when treated, and at least until the patient turns nine for a child treated before age two, with business records kept at least seven years. MassHealth requires every provider to keep its records at least six years after the date of service, or longer if the provider type’s accepted recordkeeping standards call for it.⁠^17,18,19 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.⁠^78,79

Massachusetts requires a health care provider, a term the section defines to include therapists, to let a patient or the patient’s authorized representative inspect the patient’s records and to furnish a copy on request for a reasonable fee.⁠⁸⁰ Massachusetts requires a person that owns or licenses personal information about a Massachusetts resident to notify the attorney general, the director of consumer affairs and business regulation and the resident as soon as practicable and without unreasonable delay when it knows or has reason to know of a breach of security or of unauthorized acquisition or use of the information.⁠⁸¹ Massachusetts’s child abuse reporting law makes mandated reporters of the persons it lists, including hospital personnel engaged in the examination, care or treatment of persons and any person paid to care for or work with a child in a public or private facility, home or program funded by the commonwealth, and a mandated reporter must immediately communicate with the department orally and file a written report within 48 hours. The older adult abuse law names registered physical therapists and registered occupational therapists among those who must immediately make a verbal report and a written report within 48 hours.⁠^82,83,84

Which Massachusetts rules shape a pediatric clinic?

Massachusetts Early Intervention, run by the Department of Public Health’s Early Intervention Division, whose director is the state’s Part C Coordinator, serves children from birth to three who have developmental delays or are at risk of one, at no out-of-pocket cost to families. Anyone can refer a child by contacting the Early Intervention program that serves the family’s city or town.⁠^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. Massachusetts requires insurance policies, and in parallel sections hospital service, medical service and HMO contracts, to provide benefits on a nondiscriminatory basis for the diagnosis and treatment of autism spectrum disorder, where treatment prescribed, provided or ordered as medically necessary by a licensed physician or psychologist includes habilitative or rehabilitative care such as applied behavior analysis supervised by a board certified behavior analyst and therapeutic care by licensed or certified speech therapists, occupational therapists and physical therapists. A policy’s annual or lifetime dollar or unit-of-service limits for autism may not be lower than those for physical conditions, visits to an autism services provider may not be capped, and services school personnel provide under an IEP are not reimbursed under the section.⁠^{85,86,87,88,89} The autism insurance mandates guide covers how such a mandate meets a plan’s own terms. The Catastrophic Illness in Children Relief Fund, in the Department of Public Health’s Division for Children & Youth with Special Health Needs, gives eligible Massachusetts families of children and youth under 22 financial relief for medically related expenses that insurance and other sources do not cover, and it can consider uncovered therapy expenses, including copays, coinsurance and deductibles.⁠^90,91

Which Massachusetts rules shape an adult clinic?

Medicare claims from Massachusetts go to National Government Services, the Medicare Administrative Contractor for Jurisdiction K, Part A and Part B (Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont), whose local coverage articles for therapy are the ones a Massachusetts clinic reads.⁠⁹² MassHealth’s adult therapy rules are in the Medicaid section above.

Which associations and directory pages serve Massachusetts?

The state chapters are APTA Massachusetts for physical therapy and the Massachusetts Association for Occupational Therapy (MAOT) for occupational therapy.⁠^93,94 On DrSensory, families browse Massachusetts 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.⁠⁹⁵

Which Massachusetts cities have DrSensory city pages?

Beyond its three Massachusetts pages, the directory publishes city pages for 2 Massachusetts cities, 6 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.⁠⁹⁵

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

DrSensory lists 43 PT, OT and SLP clinics in Massachusetts, on its occupational therapy, physical therapy and speech therapy pages for the state.⁠⁹⁵

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

Which templates does a Massachusetts launch need?

How might two Massachusetts clinics plan a launch?

Sources

1. Massachusetts Department of Public Health, Bureau of Health Professions Licensure. Board of Allied Health Professions. Checked October 30, 2026.
2. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 23A: Definitions applicable to Secs. 23A to 23P. Checked October 30, 2026.
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   “Physical therapy practice is evaluation, treatment and instruction related to neuromuscular, musculoskeletal, cardiovascular and respiratory functions. Such evaluation shall include but is not limited to performance and interpretation of tests as an aid to the diagnosis or planning of treatment programs.”
3. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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   “432.420: Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services. The MassHealth agency pays for all medically necessary therapy services for EPSDT-eligible members in accordance with 130 CMR 450.140 through 130 CMR 450.150, without regard to service limitations described in 130 CMR 432.000, and with prior authorization.”
4. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 6: Service Codes and Descriptions (Transmittal Letter THP-28, June 6, 2025). Checked October 30, 2026.
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   “A therapist may request prior authorization for any medically necessary service reimbursable under the federal Medicaid Act in accordance with 130 CMR 450.144, 42 U.S.C. 1396d(a), and 42 U.S.C. 1396d(r)(5) for a MassHealth Standard or CommonHealth member younger than 21 years of age, even it if is not designated as covered or payable in Subchapter 6 of the Therapist Manual.”
5. Massachusetts Department of Public Health, Bureau of Health Professions Licensure. Board of Allied Health Professions. Checked October 30, 2026.
6. Massachusetts Department of Public Health, Bureau of Health Professions Licensure. Board of Registration for Speech-Language Pathology and Audiology. Checked October 30, 2026.
7. Massachusetts Board of Allied Health Professions. 259 CMR 5.00: Physical Therapists. Checked October 30, 2026.
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   “(c) All components of clinical care, and their supporting documentation, are the sole responsibility of the physical therapist. These include: 1. Complete an initial clinical examination. 2. Determine a PT diagnosis and PT prognosis. 3. Develop a Plan of Care which is based on the initial clinical examination.”
8. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 23L: Practice of medicine or other form of healing by athletic trainer, occupational therapist, physical therapist or assistants or licensed lactation consultant. Checked October 30, 2026.
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   “Section 23L. Nothing in this section shall be construed as authorizing an athletic trainer, occupational therapist, occupational therapy assistant, physical therapist, physical therapist assistant or licensed lactation consultant to practice medicine or any other form or method of healing not specified in said section.”
9. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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   “432.415: Prescription Requirements (A) The MassHealth agency pays for only those treatments and evaluations for which the therapist has obtained written prescriptions from the member’s prescribing provider. ... (C) Prescription Renewal. The MassHealth agency pays for continuing physical, occupational, or speech/language therapy only when the prescription or plan of care is signed by the member’s prescribing provider every 60 days, and the therapist has obtained prior authorization from the MassHealth agency, as applicable, in accordance with 130 CMR 432.417. ... Prescribing Provider. The member’s physician, nurse practitioner, or physician assistant who prescribes and writes the prescription for therapy services in accordance with 130 CMR 432.415.”
10. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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    “432.411: Payable Services The MassHealth agency pays for the following therapist services subject to the conditions and limitations of 130 CMR 432.000 and 130 CMR 450.000: Administrative and Billing Regulations: (A) individual treatment; (B) initial therapy evaluation and reevaluations; (C) co-treatment; and (D) group therapy.”
11. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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    “(1) MassHealth Members. MassHealth covers therapist services only when provided to eligible MassHealth members, subject to the restrictions and limitations described in the MassHealth regulations. 130 CMR 450.105: Coverage Types specifically states, for each MassHealth coverage type, which services are covered and which members are eligible to receive those services.”
12. 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”.
13. PT Compact Commission. PT Compact Map. “Introduced Legislation (2) Illinois Massachusetts ... PT Compact Legislation Introduced but Not Enacted Yet ...” Checked October 30, 2026.
14. Occupational Therapy Compact Commission. Before You Apply for an OT Compact Privilege. “States not listed below are not a member of the Occupational Therapy Compact.” Checked October 30, 2026.
15. Audiology and Speech-Language Pathology Interstate Compact Commission. Delegate Information. Checked October 30, 2026.
16. 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.”.
17. Massachusetts Board of Allied Health Professions. 259 CMR 6.00: Physical Therapy Facilities. Checked October 30, 2026.
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    “(7) Record Retention. Patient Records and Business Records shall be maintained in a manner that protects them from foreseeable damage or destruction. ... (c) For a patient who is under the age of two when he or she receives Physical Therapy, Patient Records shall be maintained at least until the patient reaches the age of nine. (d) For patients who receive Physical Therapy on or after the patient reaches the age of two, Patient Records shall be maintained for a minimum of seven years from the date of the last patient encounter.”
18. Massachusetts Board of Allied Health Professions. 259 CMR 6.00: Physical Therapy Facilities. “(b) Business Records shall be maintained for a minimum of seven years.” Checked October 30, 2026.
19. MassHealth (Massachusetts Executive Office of Health and Human Services). 130 CMR 450.000: Administrative and Billing Regulations for All MassHealth Providers (Transmittal Letter ALL-246, April 1, 2024). Checked October 30, 2026.
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    “(G) Notwithstanding any regulatory or contractual provisions that may provide for a shorter retention period, all records described in 130 CMR 450.204 and 450.205 must be kept for at least six years after the date of medical services for which claims are made or the date services were prescribed, or for such length of time as may be dictated by the generally accepted standards for recordkeeping within the applicable provider type, whichever period is longer.”
20. Secretary of the Commonwealth of Massachusetts. Corporations Division. Checked October 30, 2026.
21. Massachusetts General Court (malegislature.gov). M.G.L. c. 156A, § 2: Definitions. Checked October 30, 2026.
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    “(b) "Professional service", (i) the service performed by registered physicians and surgeons, chiropractors, podiatrists, engineers, electrologists, physical therapists, psychologists, certified public accountants, public accountants, dentists, veterinarians, optometrists acupuncturists and registered nurses, so long as the foregoing are registered or licensed under the provisions of chapter one hundred and twelve; and by attorneys-at-law admitted to practice in the courts of the commonwealth under chapter two hundred and twenty-one; (ii) any other type of service which may be rendered only pursuant to a license pursuant to the laws of the commonwealth, if the applicable regulating boards permit the licensed person to incorporate his profession under this chapter, or if such licensed person elects to incorporate his profession under this chapter and such incorporation is not prohibited by law or by regulations of the applicable regulating board.”
22. Massachusetts Department of Public Health, Early Intervention Division. About Massachusetts Early Intervention (EI). Checked October 30, 2026.
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    “Massachusetts Early Intervention (EI) is a program for children birth to three who have developmental delays or are at risk of a developmental delay. ... Is there a cost? There are no out of pocket costs for families. Make a referral Anyone can refer a child to an Early Intervention program by contacting the program that serves their city or town.”
23. Massachusetts Department of Public Health, Early Intervention Division. Early Intervention Division. “Part C Coordinator Director, Early Intervention Division ...” Checked October 30, 2026.
24. Massachusetts Department of Public Health, Bureau of Health Professions Licensure. Board of Allied Health Professions. “We check the backgrounds of those seeking licensure in various health professions. These include occupational therapists and assistants, athletic trainers, and physical therapists and assistants.” Checked October 30, 2026.
25. Massachusetts Board of Allied Health Professions. 259 CMR 2.00: General Provisions. “2.04: Requirements for Renewal of License A license shall expire every two years on the birth anniversary of the Licensee.” Checked October 30, 2026.
26. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 23B: Board of allied health professions; examinations; applications for licensure; fees; renewal of license. Checked October 30, 2026.
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    “Licenses shall expire every 2 years on the birth anniversary of the licensee. Licensees shall pay to the board a renewal fee determined by the secretary of administration and finance. The board may require specific continuing education as a condition of license renewal.”
27. Massachusetts Board of Allied Health Professions. 259 CMR 7.00: Continuing Competence. Checked October 30, 2026.
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    “(1) Licensed physical therapists, physical therapist assistants, occupational therapists, and occupational therapy assistants (hereinafter collectively "physical therapy and occupational therapy professionals") are required, as a condition of license renewal, to complete a minimum of 24 points of Board recognized activities for maintaining continuing competence during the preceding biennial renewal period. For each renewal period, each physical and occupational therapy professional’s continuing competency points must include two points in ethics, laws and regulations governing practice in the Commonwealth of Massachusetts, or some combination thereof.”
28. Massachusetts Department of Public Health, Bureau of Health Professions Licensure. Important Renewal Information - Allied Health Professions. “As part of your renewal application, you will be required to certify that you have completed all continuing competence activities required to renew your license.” Checked October 30, 2026.
29. Massachusetts Board of Allied Health Professions. 259 CMR 5.00: Physical Therapists. Checked October 30, 2026.
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    “(b) A Physical Therapist of Record or another physical therapist accessible and willing to assume the responsibility or direction of care for that patient must be on call and readily available when physical therapy services are being provided by a physical therapist assistant. ... 8. Serve as the only supervisor of physical therapist assistants. ... b. the number of physical therapist assistants the physical therapist can safely and effectively supervise. In the absence of evidence to the contrary, the Board will presume that a ratio that exceeds one physical therapist to three physical therapist assistants is not safe and effective; ... 10. Provide supervision to the physical therapist assistant, including at a minimum: a. on-site reexamination of the Patient; b. on-site review of the Plan of Care with appropriate revision or termination ...”
30. Massachusetts Board of Allied Health Professions. 259 CMR 5.00: Physical Therapists. “(a) Work under the supervision of a licensed physical therapist. (b) Cannot initiate a treatment program without prior evaluation and the development of a Plan of Care by the Physical Therapist of Record.” Checked October 30, 2026.
31. Massachusetts Board of Allied Health Professions. 259 CMR 6.00: Physical Therapy Facilities. Checked October 30, 2026.
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    “6.02: Facility Standards (1) Delivery of Physical Therapy. Physical Therapy may only be delivered at a place, office, clinic or establishment holding a current, valid Physical Therapy Facility license issued by the Board or in practices or facilities that are exempted from licensure under 259 CMR 6.02(3). (2) License Required. Each Physical Therapy Facility within the Commonwealth shall be licensed by the Board before providing Physical Therapy and shall annually renew its license using an application provided by the Board. ... (3) Exemptions. (a) Solo Practices are exempted from the Physical Therapy Facility requirements but are held to all standards, rules and regulations of individual Physical Therapists. (b) Physical Therapy Facility licenses are not required for healthcare facilities licensed by the Massachusetts Department of Public Health including but not limited to hospitals, clinics, and home health care agencies, or institutions regulated by the Department of Education ...”
32. Massachusetts Board of Allied Health Professions. 259 CMR 2.00: General Provisions. Checked October 30, 2026.
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    “Physical Therapy Facility. A place, office, clinic or establishment in which Physical Therapy is provided on a predictable or regular basis, or in which business and patient records related to physical therapy are used or stored, which has been licensed by the Board. A Physical Therapy Facility must have a PT Compliance Officer.”
33. Massachusetts Board of Allied Health Professions. 259 CMR 2.00: General Provisions. Checked October 30, 2026.
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    “Solo Practice. A place, office, clinic or establishment in which Physical Therapy is provided or in which Business Records or Patient Records related to Physical Therapy are used or stored, and where Physical Therapy is solely provided by one primary Physical Therapist who owns at least 51% of the business and operates the Physical Therapy Practice.”
34. Massachusetts Board of Allied Health Professions. 259 CMR 2.00: General Provisions. “2.04: Requirements for Renewal of License A license shall expire every two years on the birth anniversary of the Licensee.” Checked October 30, 2026.
35. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 23B: Board of allied health professions; examinations; applications for licensure; fees; renewal of license. Checked October 30, 2026.
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    “Licenses shall expire every 2 years on the birth anniversary of the licensee. Licensees shall pay to the board a renewal fee determined by the secretary of administration and finance. The board may require specific continuing education as a condition of license renewal.”
36. Massachusetts Board of Allied Health Professions. 259 CMR 7.00: Continuing Competence. Checked October 30, 2026.
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    “(1) Licensed physical therapists, physical therapist assistants, occupational therapists, and occupational therapy assistants (hereinafter collectively "physical therapy and occupational therapy professionals") are required, as a condition of license renewal, to complete a minimum of 24 points of Board recognized activities for maintaining continuing competence during the preceding biennial renewal period. For each renewal period, each physical and occupational therapy professional’s continuing competency points must include two points in ethics, laws and regulations governing practice in the Commonwealth of Massachusetts, or some combination thereof.”
37. Massachusetts Department of Public Health, Bureau of Health Professions Licensure. Important Renewal Information - Allied Health Professions. “As part of your renewal application, you will be required to certify that you have completed all continuing competence activities required to renew your license.” Checked October 30, 2026.
38. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 23A: Definitions applicable to Secs. 23A to 23P. “... a person duly licensed in accordance with section twenty-three B and who assists in the practice of occupational therapy who works under the supervision of a duly licensed occupational therapist.” Checked October 30, 2026.
39. Massachusetts Board of Allied Health Professions. 259 CMR 3.00: Occupational Therapists. “(d) Occupational therapy assistants may not initiate or alter an Intervention Plan without prior Evaluation by and approval of the supervising occupational therapist.” Checked October 30, 2026.
40. Massachusetts Board of Allied Health Professions. 259 CMR 3.00: Occupational Therapists. Checked October 30, 2026.
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    “(1) Primary responsibility for occupational therapy services rendered by supportive personnel rests with the supervising occupational therapist. (2) Occupational therapists and occupational therapy assistants must exercise their professional judgment when determining the number of personnel they can safely and effectively supervise to ensure that safe and appropriate care is provided at all times.”
41. Massachusetts Department of Public Health, Bureau of Health Professions Licensure. Board of Registration for Speech-Language Pathology and Audiology. “We license people who would like to work in speech therapy. Our job is to protect the health, safety, and welfare of the public.” Checked October 30, 2026.
42. Massachusetts Board of Registration for Speech-Language Pathology and Audiology. 260 CMR 5.00: Renewal Procedures. “5.01: License Renewal Licenses must be renewed every two years. The Board will issue licenses so as to establish a birth date expiration.” Checked October 30, 2026.
43. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 143: Speech-language pathologists and audiologists; license renewal; fee. “Section 143. A licensed speech-language pathologist or audiologist or certified speech-language pathology assistant or audiology assistant shall apply to the board every 2 years on dates determined by the board for renewal of such license or certificate ...” Checked October 30, 2026.
44. Massachusetts Board of Registration for Speech-Language Pathology and Audiology. 260 CMR 7.00: Continuing Education. Checked October 30, 2026.
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    “1. Licensees holding a license as either a Speech-language Pathologist or Audiologist are required, as a condition of license renewal, to complete a minimum of the equivalent of 20 Continuing Education Hours per licensure renewal period (every two years). A minimum of ten of the total 20 Continuing Education Hours must be completed in the licensee’s area of licensure.”
45. Massachusetts Board of Registration for Speech-Language Pathology and Audiology. 260 CMR 10.00: Use and Supervision of Speech-Language Pathology and Audiology Assistants. Checked October 30, 2026.
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    “(2) The supervisor is responsible for the services provided by assistants. ... (a) At least 10% of services rendered by Assistants each month must be provided under Direct Supervision. An additional 10% of services must be supervised, either directly or indirectly. ... (6) A supervisor may not supervise more than three assistants at any given time.”
46. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 138: Definitions applicable to Secs. 138 to 147. “... a person duly certified in accordance with section 139 who assists in the practice of speech-language pathology and who works under the supervision and direction of a duly licensed speech-language pathologist.” Checked October 30, 2026.
47. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 23A: Definitions applicable to Secs. 23A to 23P. “Occupational therapy includes but is not limited to: (1) administering and interpreting tests necessary for effective treatment planning; (2) developing daily living skills, perceptual motor skills, sensory integrative functioning, play skills and prevocational and vocational work capacities ...” Checked October 30, 2026.
48. Massachusetts Board of Allied Health Professions. 259 CMR 3.00: Occupational Therapists. Checked October 30, 2026.
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    “(h) Initiates and directs the Evaluation process, analyzes and interprets the data in accordance with applicable laws, other regulatory requirements, and AOTA documents. ... (i) Assumes primary responsibility for the development of the occupational therapy Intervention Plan based on the initial Evaluation, including long and short term goals, expected frequency, and duration.”
49. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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    “432.415: Prescription Requirements (A) The MassHealth agency pays for only those treatments and evaluations for which the therapist has obtained written prescriptions from the member’s prescribing provider. ... (C) Prescription Renewal. The MassHealth agency pays for continuing physical, occupational, or speech/language therapy only when the prescription or plan of care is signed by the member’s prescribing provider every 60 days, and the therapist has obtained prior authorization from the MassHealth agency, as applicable, in accordance with 130 CMR 432.417. ... Prescribing Provider. The member’s physician, nurse practitioner, or physician assistant who prescribes and writes the prescription for therapy services in accordance with 130 CMR 432.415.”
50. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 138: Definitions applicable to Secs. 138 to 147. “"Speech-language pathology", the application of principles, methods and procedures of measurement, prediction, evaluation, testing, counseling, consultation and remediation related to the development and disorders of speech and language.” Checked October 30, 2026.
51. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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    “432.415: Prescription Requirements (A) The MassHealth agency pays for only those treatments and evaluations for which the therapist has obtained written prescriptions from the member’s prescribing provider. ... (C) Prescription Renewal. The MassHealth agency pays for continuing physical, occupational, or speech/language therapy only when the prescription or plan of care is signed by the member’s prescribing provider every 60 days, and the therapist has obtained prior authorization from the MassHealth agency, as applicable, in accordance with 130 CMR 432.417. ... Prescribing Provider. The member’s physician, nurse practitioner, or physician assistant who prescribes and writes the prescription for therapy services in accordance with 130 CMR 432.415.”
52. MassHealth (Massachusetts Executive Office of Health and Human Services). New MassHealth Providers. Checked October 30, 2026.
53. 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.”.
54. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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    “(B) Services that Require Prior Authorization. The MassHealth agency requires that the therapist obtain prior authorization as a prerequisite to payment for the following services to eligible MassHealth members: (1) more than 20 occupational-therapy visits or 20 physical-therapy visits, including group- therapy visits but not including evaluations, for a member in a 12-month period; (2) more than 35 speech/language therapy visits, including group-therapy visits but not including evaluations, for a member in a 12-month period; and (3) more than two evaluations in a 12-month period.”
55. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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    “(C) Prescription Renewal. The MassHealth agency pays for continuing physical, occupational, or speech/language therapy only when the prescription or plan of care is signed by the member’s prescribing provider every 60 days, and the therapist has obtained prior authorization from the MassHealth agency, as applicable, in accordance with 130 CMR 432.417.”
56. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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    “(D) Members in Capitated Programs. For those members who are enrolled in MassHealth capitated programs, the therapy provider must follow the capitated program’s specific prior authorization procedures, where applicable, for therapy services.”
57. MassHealth (masshealthchoices.com, enrollment site). Choosing a health plan. “You choose the type of health plan you want. We offer these 3 types of plans: Accountable Care Organizations (ACOs) Managed Care Organizations (MCOs) Primary Care Clinician (PCC) plan ...” Checked October 30, 2026.
58. MassHealth (masshealthchoices.com, enrollment site). Do you need to choose a health plan?. Checked October 30, 2026.
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    “Some MassHealth members need to enroll in a health plan. Use this website if you: Are under age 65 Do not have other insurance, including Medicare Live in the community (for example, not in a nursing home), and Are in MassHealth Standard, CommonHealth, CarePlus, or Family Assistance.”
59. MassHealth (masshealthchoices.com, enrollment site). Choosing a health plan. “There are 2 types of ACOs you can enroll in: Accountable Care Partnership plans or Primary Care ACO plans.” Checked October 30, 2026.
60. Massachusetts Executive Office of Health and Human Services. 101 CMR 339.00: Rates for Restorative Services. Checked October 30, 2026.
61. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). Checked October 30, 2026.
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    “The MassHealth agency pays for services set forth at 130 CMR 432.411(A) through (D) when provided by therapists or by PTAs, OTAs, and SLPAs subject to the supervision requirements of 130 CMR 432.000. Service provided by supervised PTAs, OTAs, or SLPAs must be billed using the MassHealth provider ID of the supervising MassHealth-enrolled therapist.”
62. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 4: 130 CMR 432.000, Therapist Services (Transmittal Letter THP-29, July 31, 2026). “432.414: Service Limitations (A) The MassHealth agency pays a therapist for no more than one individual treatment and one group therapy session per member per day.” Checked October 30, 2026.
63. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 6: Service Codes and Descriptions (Transmittal Letter THP-28, June 6, 2025). Checked October 30, 2026.
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    “Unless otherwise indicated, the maximum allowable number of units for therapeutic treatment is four per therapy visit (e.g., maximum of one hour per member per visit per day). ... Modifier GP, an information modifier indicating the services are delivered under an Outpatient Physical Therapy Plan of Care, may be applied to any of the below procedure codes for further specificity.”
64. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 6: Service Codes and Descriptions (Transmittal Letter THP-28, June 6, 2025). Checked October 30, 2026.
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    “Unless otherwise indicated, the maximum allowable number of units for individual therapeutic treatment is four per therapy visit (e.g., a maximum of one hour per member per visit per day), ... Modifier GO, an information modifier indicating the services are delivered under an Outpatient Occupational Therapy Plan of Care, may be applied to any of the below procedure codes for further specificity.”
65. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 6: Service Codes and Descriptions (Transmittal Letter THP-28, June 6, 2025). “Modifier GN is an information modifier indicating the services are delivered under an Outpatient Speech/Language Pathology Plan of Care, may be applied to any of the below procedure codes for further specificity.” Checked October 30, 2026.
66. MassHealth (Massachusetts Executive Office of Health and Human Services). What is the School-Based Medicaid Program (SBMP)?. Checked October 30, 2026.
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    “The School-Based Medicaid Program (SBMP) offers Local Education Agencies (LEAs) an opportunity to receive federal dollars to offset costs for providing certain Medicaid-covered direct services in a school setting. ... Covered types of direct care services in the SBMP include: Applied Behavior Analysis for members with Autism Spectrum Disorder (ASD), audiology, dental assessments/screenings, medical nutritional services, mental/behavioral health services, skilled nursing care, occupational therapy, physical therapy, physical and behavioral health screenings, and speech therapy.”
67. MassHealth (Massachusetts Executive Office of Health and Human Services). Therapist Manual, Subchapter 6: Service Codes and Descriptions (Transmittal Letter THP-28, June 6, 2025). “(2) Modifier GT is an informational modifier (indicating the services are conducted via interactive audio and video telecommunication systems). Telehealth codes may only be used when clinically appropriate.” Checked October 30, 2026.
68. Massachusetts Board of Registration for Speech-Language Pathology and Audiology. Board Policies and Guidelines (Speech-Language Pathology and Audiology): Policy No. 2019-001, Providing Speech-Language Pathology and Audiology Services by Electronic Means (amended August 1, 2022). Checked October 30, 2026.
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    “Telepractice is a permitted mode of practice in Massachusetts subject to the terms of this Policy. Licensure All persons who provide telepractice services to clients who reside or are located in Massachusetts must be licensed by the Board. ... The scope, nature and quality of telepractice services must be equivalent to the quality of services delivered face-to-face and in-person. Before providing telepractice services, a speech-language pathologist or audiologist must obtain ten (10) hours of training in telepractice in classroom courses or via distance learning.”
69. Massachusetts Board of Registration for Speech-Language Pathology and Audiology. Board Policies and Guidelines (Speech-Language Pathology and Audiology): Policy No. 2019-001, Providing Speech-Language Pathology and Audiology Services by Electronic Means (amended August 1, 2022). Checked October 30, 2026.
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    “Give the client written notification of telepractice services, including notification of: The limitations of using technology in providing telepractice; The potential risks to the confidentiality of information due to technology used in telepractice; ... The client’s right to refuse or discontinue telepractice services; ... Obtain the signature of the client or the parent or guardian of a minor client on this written document, and maintain this document in the clinical record.”
70. Massachusetts General Court (malegislature.gov). M.G.L. c. 175, § 47MM: Coverage for health care services delivered via telehealth. Checked October 30, 2026.
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    “(h) Health care services provided via telehealth shall conform to the standards of care applicable to the telehealth provider’s profession and specialty. Such services shall also conform to applicable federal and state health information privacy and security standards as well as standards for informed consent.”
71. Massachusetts General Court (malegislature.gov). M.G.L. c. 175, § 47MM: Coverage for health care services delivered via telehealth. Checked October 30, 2026.
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    “(b) An individual policy of accident and sickness insurance issued under section 108 that provides hospital expense and surgical expense insurance and any group blanket or general policy of accident and sickness insurance issued under section 110 that provides hospital expense and surgical expense insurance that is issued or renewed within or without the commonwealth shall provide coverage for health care services delivered via telehealth by a contracted health care provider if: (i) the health care services are covered by way of in-person consultation or delivery; and (ii) the health care services may be appropriately provided through the use of telehealth; ... (e) A policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth that provides coverage for telehealth services may include a deductible, copayment or coinsurance requirement for a health care service provided via telehealth as long as the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to an in-person consultation or in-person delivery of services.”
72. Massachusetts General Court (malegislature.gov). M.G.L. c. 175, § 47MM: Coverage for health care services delivered via telehealth. Checked October 30, 2026.
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    “(g) Insurance companies organized under this chapter shall ensure that the rate of payment for in-network providers of behavioral health services delivered via interactive audio-video technology and audio-only telephone shall be no less than the rate of payment for the same behavioral health service delivered via in-person methods ...”
73. Massachusetts Department of Revenue. MassTaxConnect. Checked October 30, 2026.
74. Massachusetts Department of Revenue. Sales and Use Tax. Checked October 30, 2026.
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    “The following categories of sales or types of transactions are generally exempted from the sales/use tax: ... Personal or professional services Services such as: Accounting Insurance Legal and medical services Haircuts Car repairs Items sold along with services (e.g., a bottle of shampoo from a salon, parts for a car repair), are taxable and must be itemized separately on the bill.”
75. Massachusetts Department of Revenue. Sales and Use Tax. “The law generally determines whether health care items and equipment are taxable or not. Rentals, sales, and repairs of the following are only exempt when prescribed by a registered physician ...” Checked October 30, 2026.
76. Massachusetts Department of Industrial Accidents. Workers’ Compensation Insurance Requirements. Checked October 30, 2026.
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    “All employers operating in Massachusetts are required to carry workers’ compensation insurance for their employees and themselves if they are an employee of their company. The requirement applies no matter the number of hours worked or the number of employees. ... Members of a limited liability company (LLC), partners of a limited liability partnership (LLP), or sole proprietors of an unincorporated business aren’t required to carry workers’ compensation insurance for themselves ...”
77. Massachusetts General Court (malegislature.gov). M.G.L. c. 152, § 25A: Insurance or self-insurance by employers. Checked October 30, 2026.
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    “Section 25A. In order to promote the health, safety and welfare of employees, every employer shall provide for the payment to his employees of the compensation provided for by this chapter in the following manner: (1) By insurance with an insurer or by membership in a workers’ compensation self-insurance group, established pursuant to the provisions of sections twenty-five E to twenty-five U, inclusive, or (2) Subject to the rules of the department, by obtaining from the department annually a license as a self-insurer ...”
78. 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.”.
79. 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.”.
80. Massachusetts General Court (malegislature.gov). M.G.L. c. 112, § 12CC: Health care providers; inspection of records. Checked October 30, 2026.
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    “Section 12CC. A health care provider who maintains records for a patient treated or examined by such provider shall permit inspection of such records by such patient or an authorized representative of the patient, and upon request a copy of such patient’s record shall be furnished upon payment of a reasonable fee, ... For purposes of this section, "health care provider" shall mean a person or entity providing medical care or services, including but not limited to, physicians and surgeons, therapists, dentists, nurses, optometrists, chiropractors, psychologists, and podiatrists.”
81. Massachusetts General Court (malegislature.gov). M.G.L. c. 93H, § 3: Duty to report known security breach or unauthorized use of personal information. Checked October 30, 2026.
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    “(b) A person or agency that owns or licenses data that includes personal information about a resident of the commonwealth, shall provide notice, as soon as practicable and without unreasonable delay, when such person or agency (1) knows or has reason to know of a breach of security or (2) when the person or agency knows or has reason to know that the personal information of such resident was acquired or used by an unauthorized person or used for an unauthorized purpose, to the attorney general, the director of consumer affairs and business regulation and to such resident, in accordance with this chapter.”
82. Massachusetts General Court (malegislature.gov). M.G.L. c. 119, § 21: Definitions applicable to Secs. 21 to 51H. Checked October 30, 2026.
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    “"Mandated reporter", a person who is: (i) a physician, medical intern, hospital personnel engaged in the examination, care or treatment of persons, medical examiner, psychologist, emergency medical technician, dentist, nurse, chiropractor, podiatrist, optometrist, osteopath, allied mental health and human services professional licensed under section 165 of chapter 112, drug and alcoholism counselor, psychiatrist or clinical social worker; (ii) a public or private school teacher, educational administrator, guidance or family counselor, child care worker, person paid to care for or work with a child in any public or private facility, or home or program funded by the commonwealth or licensed under chapter 15D that provides child care or residential services to children ...”
83. Massachusetts General Court (malegislature.gov). M.G.L. c. 119, § 51A: Reports of suspected abuse or neglect of children. Checked October 30, 2026.
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    “Section 51A. (a) A mandated reporter shall immediately communicate with the department orally and shall, within 48 hours, file a written report with the department detailing suspected abuse or neglect if, in their professional capacity, they have reasonable cause to believe that a child is ...”
84. Massachusetts General Court (malegislature.gov). M.G.L. c. 19A, § 15: Reports of abuse of older adults. Checked October 30, 2026.
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    “Section 15. (a) Any physician, physician assistant, medical intern, dentist, nurse, family counselor, probation officer, social worker, policeman, firefighter, emergency medical technician, animal control officer, licensed psychologist, coroner, registered physical therapist, registered occupational therapist, osteopath, podiatrist, director of a council on aging, outreach worker employed by a council on aging, executive director of a licensed home health agency or executive director of a homemaker service agency or manager of an assisted living residence who has reasonable cause to believe that an older adult is suffering from or has died as a result of abuse, shall immediately make a verbal report of such information or cause a report to be made to the department or its designated agency and shall within forty-eight hours make a written report to the department or its designated agency ...”
85. Massachusetts General Court (malegislature.gov). M.G.L. c. 175, § 47AA: Coverage for diagnosis and treatment of autism spectrum disorder. Checked October 30, 2026.
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    “"Therapeutic care", services provided by licensed or certified speech therapists, occupational therapists, physical therapists or social workers. "Treatment of autism spectrum disorders", includes the following care prescribed, provided or ordered for an individual diagnosed with 1 of the autism spectrum disorders by a licensed physician or a licensed psychologist who determines the care to be medically necessary: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care. (b) An individual policy of accident and sickness insurance issued under section 108 that provides hospital expense and surgical expense insurance and any group blanket or general policy of accident and sickness insurance issued under section 110 that provides hospital expense and surgical expense insurance, which is issued or renewed within or without the commonwealth, shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the diagnosis and treatment of autism spectrum disorder in individuals. (c) Such policy shall be in compliance with subsection (b) if the policy does not contain annual or lifetime dollar or unit of service limitation on coverage for the diagnosis and treatment of autism spectrum disorders which is less than a annual or lifetime dollar or unit of service limitation imposed on coverage for the diagnosis and treatment of physical conditions. ... (e) Coverage under this section shall not be subject to a limit on the number of visits an individual may make to an autism services provider. (f) This section shall not affect an obligation to provide services to an individual under an individualized family service plan, an individualized education program or an individualized service plan. Services related to autism spectrum disorder provided by school personnel under an individualized education program are not subject to reimbursement under this section.”
86. Massachusetts General Court (malegislature.gov). M.G.L. c. 175, § 47AA: Coverage for diagnosis and treatment of autism spectrum disorder. Checked October 30, 2026.
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    “"Habilitative or rehabilitative care", professional, counseling and guidance services and treatment programs, including, but not limited to, applied behavior analysis supervised by a board certified behavior analyst, that are necessary to develop, maintain and restore, to the maximum extent practicable, the functioning of an individual.”
87. Massachusetts General Court (malegislature.gov). M.G.L. c. 176A, § 8DD. Checked October 30, 2026.
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    “(b) A contract between a subscriber and the corporation under an individual or group hospital service plan which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the diagnosis and treatment of autism spectrum disorder in individuals.”
88. Massachusetts General Court (malegislature.gov). M.G.L. c. 176B, § 4DD. Checked October 30, 2026.
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    “(b) A subscription certificate under an individual or group medical service agreement which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the diagnosis and treatment of autism spectrum disorder in individuals.”
89. Massachusetts General Court (malegislature.gov). M.G.L. c. 176G, § 4V. Checked October 30, 2026.
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    “(b) A health maintenance contract issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the diagnosis and treatment of autism spectrum disorder in individuals.”
90. Massachusetts Department of Public Health, Division for Children & Youth with Special Health Needs. What expenses are covered by CICRF?. “Medical Expenses: The Fund can consider expenses such as uncovered hospital, physician, laboratory, ambulance and therapy expenses (self-pay, copays/coinsurance/deductibles) .” Checked October 30, 2026.
91. Massachusetts Department of Public Health, Division for Children & Youth with Special Health Needs. Catastrophic Illness in Children Relief Fund (CICRF). Checked October 30, 2026.
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    “The Catastrophic Illness in Children Relief Fund (CICRF) provides financial relief to eligible Massachusetts families caring for children and youth under 22 years of age with medically related expenses that are not covered by insurance, federal or state assistance, fundraising, or any other financial source.”
92. Centers for Medicare & Medicaid Services. Medicare Administrative Contractors (MACs). “K Connecticut, New York, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont ... National Government Services, Inc.” Checked October 30, 2026.
93. APTA Massachusetts. APTA Massachusetts (the state association's site). Checked October 30, 2026.
94. the Massachusetts Association for Occupational Therapy (MAOT). the Massachusetts Association for Occupational Therapy (MAOT) (the state association's site). Checked October 30, 2026.
95. DrSensory. Occupational therapy clinics in Massachusetts, 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.
96. 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 Massachusetts, not legal, compliance, billing or financial advice. Rules change; the clinic confirms each with its source before acting on it.