Michigan PT, OT and SLP guide

For OT, PT and SLP clinics in Michigan: three state boards license the disciplines; a patient may start physical therapy without a prescription for 21 days or 10 treatments, whichever comes first; Michigan Medicaid covers children’s therapy under EPSDT and adults within its own rules; and telehealth follows the patient’s location. Every rule here is quoted from its source.⁠^1,2,3

Who licenses OTs, PTs and SLPs in Michigan?

Three state boards license the three disciplines in Michigan, and each publishes its own licensing law, rules, renewal cycle and continuing-education requirement.⁠^1,4,5 A clinic that employs more than one discipline keeps three registers, not one.

Physical therapists and physical therapist assistants answer to the Michigan Board of Physical Therapy.⁠^1,26,27,28 Occupational therapists and occupational therapy assistants answer to the Michigan Board of Occupational Therapists.⁠^4,29,30,31 Speech-language pathologists answer to the Michigan Board of Speech-Language Pathology.⁠^5,32,33,34 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 Michigan 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.⁠^1,4,5 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 Michigan 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 without a prescription for 21 days or 10 treatments, whichever comes first, or when the patient seeks physical therapy to prevent injury or promote fitness; past that point treatment needs a prescription from an advanced practice registered nurse or a holder of a license under part 166, 170, 175 or 180 of the Public Health Code, and a physical therapist treating without a prescription refers the patient to an appropriate health care professional when symptoms or conditions call for services beyond physical therapy.⁠^2,6,7,8 For occupational therapy, the Public Health Code defines occupational therapy services, including evaluation of daily living, education, work and play, and requires a license to practice them; vision therapy and low vision rehabilitation services need a referral or prescription from, or supervision or comanagement by, a physician licensed under part 170 or 175 or an optometrist. Michigan Medicaid, as a payer, requires a prescription from a physician or other licensed practitioner for outpatient hospital, private clinic and nursing facility occupational therapy.⁠^35,36,37 For speech-language pathology, a speech-language pathologist assesses or treats swallowing disorders and medically related communication disorders only on referral from a physician (MD or DO) or an advanced practice registered nurse, and refers a patient to a physician when signs or symptoms suggest an underlying medical condition; Michigan Medicaid, as a payer, requires a prescription from a physician or other licensed practitioner for outpatient hospital, private clinic and nursing facility speech-language therapy.⁠^38,39,40

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.⁠¹⁹ Michigan 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 Michigan Medicaid pay for pediatric and adult therapy?

Michigan Medicaid is run by the Michigan Department of Health and Human Services, and a clinic enrolls through its provider enrollment route before it bills.⁠⁴¹ 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.⁠⁴² For beneficiaries under 21, Michigan Medicaid covers medically necessary habilitative therapy as well as rehabilitative therapy, and the manual cites federal EPSDT regulations requiring coverage of medically necessary treatment under 21, habilitative therapy included.⁠³

Michigan Medicaid covers medically necessary rehabilitative occupational, physical and speech therapy for beneficiaries of all ages, and adults in the Healthy Michigan Plan may also be eligible for habilitative therapy. For outpatient and private clinic therapy the standard of coverage is up to 144 units of OT and 144 units of PT per calendar year and up to 36 visits of ST, with prior authorization required for treatment that exceeds those limits.⁠⁹ Outpatient and private clinic therapy needs prior authorization once the therapy limits are exceeded, regardless of diagnosis, and continued therapy may be authorized for up to six months at a time. Requests go in through CHAMPS by direct data entry, or on form MSA-115 to the MDHHS Program Review Division.⁠⁴³ MDHHS contracts with Medicaid Health Plans, chosen by competitive bid, which must cover speech, language, physical and occupational therapies and may set prior authorization requirements and utilization review criteria that differ from Medicaid’s, so a clinic checks each plan’s prior authorization requirements for its members.⁠^44,45 The fee schedule is published by the agency, and a clinic reads the current file rather than a remembered rate.⁠⁴⁶

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

Every Michigan Medicaid therapy claim line carries the discipline’s plan of care modifier, GP for physical therapy, GO for occupational therapy and GN for speech-language pathology, plus 96 for habilitative or 97 for rehabilitative service and TS for maintenance therapy. Services by students, graduates, educational limited temporary licensees and assistants are reported under the supervising therapist’s NPI, and a telemedicine therapy service adds modifier 95.⁠^47,48,49 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 Michigan Medicaid pay for therapy in schools?

The School Services Program pays enrolled intermediate school districts, their local education agencies, the Detroit Public Schools Community District and the Michigan School for the Deaf for direct medical services to students up to age 21 who are eligible under IDEA or have an IEP or IFSP. A child may receive medically based therapy in the community as well, with distinct goals in each setting.⁠^50,51 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 Michigan Medicaid cover therapy by telehealth?

Michigan Medicaid allows select therapy services by telemedicine from enrolled private clinic and outpatient hospital therapy providers, but not initial PT and OT evaluations or oral motor and swallowing services, and telemedicine visits count toward the beneficiary’s therapy limits.⁠⁵² The telehealth section below covers the state’s own rules for the session itself.

What are Michigan’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.⁠¹⁰ MCL 333.16284, in the Public Health Code, bars a health professional from providing a telehealth service without directly or indirectly obtaining consent for treatment, and the physical therapy, occupational therapy and speech-language pathology rules require the licensee to keep proof of that consent in the patient’s medical record, act within the scope of practice and exercise the same standard of care as for an in-person service. For occupational therapy, a parent or legal guardian consents for a patient under 18.⁠^53,54,55,56

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.⁠^11,12,13 MCL 500.3476, in the Insurance Code, bars an insurer from requiring face-to-face contact for services appropriately provided through telemedicine, as the insurer determines, subjects telemedicine to the policy’s usual copayments, coinsurance and deductibles, and requires the professional to be licensed or otherwise authorized in the state where the patient is located. MCL 550.1401k sets the same requirements for health care corporation certificates.⁠^57,58

Which business steps are specific to Michigan?

The entity is registered with the Corporations Division of the Department of Licensing and Regulatory Affairs, and the choice of entity is shaped by the state’s rule on who may own a therapy business.⁠²² A professional corporation that provides a professional service subject to article 15 of the Public Health Code must have every shareholder licensed or legally authorized in Michigan to provide the same professional service, and a professional limited liability company that renders a professional service included within the Public Health Code must have all members and managers licensed or legally authorized in Michigan to render the same service.⁠^23,24 State tax registration is with the Department of Treasury, through its online business registration for a sales tax license and other business taxes.⁠⁵⁹ Michigan’s 6% sales tax is owed by individuals or businesses that sell tangible personal property to the final consumer, levied under the General Sales Tax Act on persons in the business of making sales at retail by which ownership of tangible personal property is transferred. The act exempts the sale of a prosthetic device, durable medical equipment or mobility enhancing equipment.⁠^60,61,62 Michigan’s workers’ compensation act applies to private employers that regularly employ 3 or more employees at one time, or fewer than 3 if at least 1 has been regularly employed for 35 or more hours a week for 13 weeks or longer during the preceding 52 weeks, and each employer under the act must secure payment of compensation through an authorized insurer or the director’s authorization to self-insure.⁠^63,64 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 Michigan?

MCL 333.16213, in the Public Health Code, requires every licensee to keep a full and complete record for each patient and, unless a longer period is required by other law or generally accepted standards, to retain it for a minimum of 7 years from the date of service. A record less than 7 years old may be destroyed only after written notice to the patient and the patient’s written authorization. Michigan Medicaid’s therapy chapter also requires therapy providers to keep all applicable documentation in the beneficiary’s medical record for seven years.⁠^20,21 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.⁠^65,66

MCL 445.72, in the Identity Theft Protection Act, requires a person or agency that owns or licenses data in a database and discovers a security breach to provide a notice of the breach to each resident of the state whose unencrypted personal information was accessed and acquired by an unauthorized person, without unreasonable delay, unless it determines the breach is not likely to cause substantial loss or injury or result in identity theft.⁠⁶⁷ Michigan’s Child Protection Law names physical therapists, physical therapist assistants, occupational therapists and audiologists among the professionals who must make an immediate report to centralized intake, by telephone or the online reporting system, when they have reasonable cause to suspect child abuse or neglect, and file a written report within 72 hours of a telephone report.⁠⁶⁸

Which Michigan rules shape a pediatric clinic?

Early On is Michigan’s early intervention system for infants and toddlers from birth to three with a disability, developmental delay or a health condition that puts them at risk of delay, offered by MiLEAP as the state’s lead agency for Part C of IDEA. A family or clinician refers a child by calling 1-800-EarlyOn (800-327-5966) or through the online referral form.⁠²⁵ 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. MCL 500.3406s, in the Insurance Code, requires health insurance policies to cover diagnosis and treatment of autism spectrum disorders, and treatment includes therapeutic care by a licensed or certified speech therapist, occupational therapist or physical therapist when a licensed physician or psychologist prescribes or orders it as medically necessary. An insurer may not limit the number of visits or deny coverage because treatment is educational or habilitative, and may limit coverage to age 18 with annual maximums of $50,000 through age 6, $40,000 from 7 through 12 and $30,000 from 13 through 18.⁠⁶⁹ The autism insurance mandates guide covers how such a mandate meets a plan’s own terms. Children’s Special Health Care Services, an MDHHS program, covers care and treatment related to a qualifying diagnosis, one of more than 2,700 physical conditions but not developmental, behavioral or intellectual conditions, for clients under 26. The Medicaid therapy chapter covers medically necessary services related to a CSHCS qualifying diagnosis as a CSHCS authorized subspecialist recommends, and home health speech therapy only for CSHCS beneficiaries.⁠^70,71

Which Michigan rules shape an adult clinic?

Medicare claims from Michigan go to Wisconsin Physicians Service Government Health Administrators (WPS), the Medicare Administrative Contractor for Jurisdiction 8, Part A and Part B (Indiana and Michigan), whose local coverage articles for therapy are the ones a Michigan clinic reads.⁠⁷² Michigan Medicaid’s adult therapy rules are in the Medicaid section above. The Workers’ Disability Compensation Agency publishes the 2025 Health Care Services rule set’s calculations of the maximum allowable payment for medical care, treatment, procedures and devices, and its rules name physical therapists and occupational therapists among the providers of physical treatment, with physical medicine evaluation codes limited to licensed physical therapists, licensed occupational therapists and licensed practitioners.⁠^73,74

Which associations and directory pages serve Michigan?

The state chapters are APTA Michigan for physical therapy, the Michigan Occupational Therapy Association for occupational therapy and the Michigan Speech Language Hearing Association for speech-language pathology.⁠^75,76,77 On DrSensory, families browse Michigan 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.⁠⁷⁸

Which Michigan cities have DrSensory city pages?

Beyond its three Michigan pages, the directory publishes city pages for 4 Michigan cities, 10 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.⁠⁷⁸

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

DrSensory lists 57 PT, OT and SLP clinics in Michigan, on its occupational therapy, physical therapy and speech therapy pages for the state.⁠⁷⁸

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

Which templates does a Michigan launch need?

How might two Michigan clinics plan a launch?

Sources

1. Michigan Department of Licensing and Regulatory Affairs. Michigan Board of Physical Therapy. Checked October 30, 2026.
2. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.17820, Public Health Code. Checked October 30, 2026.
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   “A physical therapist or a physical therapist assistant may engage in the treatment of a patient without the prescription of a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state, under either of the following circumstances: (a) For 21 days or 10 treatments, whichever first occurs. However, a physical therapist shall determine that the patient’s condition requires physical therapy before delegating physical therapy interventions to a physical therapist assistant. (b) The patient is seeking physical therapy services for the purpose of preventing injury or promoting fitness.”
3. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). Checked October 30, 2026.
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   “Medicaid covers medically necessary rehabilitative therapy services for beneficiaries of all ages. ... Medicaid beneficiaries under 21 years of age and Healthy Michigan Plan beneficiaries may be eligible for medically necessary habilitative therapy services. ... Federal EPSDT regulations require coverage of medically necessary treatment for beneficiaries under 21 years of age, including medically necessary habilitative therapy services.”
4. Michigan Department of Licensing and Regulatory Affairs. Michigan Board of Occupational Therapists. Checked October 30, 2026.
5. Michigan Department of Licensing and Regulatory Affairs. Michigan Board of Speech-Language Pathology. Checked October 30, 2026.
6. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.17824, Public Health Code. Checked October 30, 2026.
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   “(2) A physical therapist who is treating a patient without a prescription from a health care professional under the conditions authorized in section 17820 shall do all of the following, as applicable: (a) Refer the patient to an appropriate health care professional for treatment if the physical therapist has reasonable cause to believe that symptoms or conditions are present that require services beyond the scope of practice of physical therapy.”
7. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.17825, Public Health Code. Checked October 30, 2026.
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   “This part does not require new or additional third party reimbursement or mandated worker’s compensation benefits for physical therapy services and does not preclude a third party payer from requiring a member or enrollee to fulfill benefit requirements for physical therapy services, including, but not limited to, prescription, referral, or preapproval when services are rendered by an individual licensed or otherwise authorized under this part.”
8. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). “Outpatient hospital, private practice, and nursing facility therapy requires a prescription from a physician or other licensed practitioner practicing within their scope of practice as defined in State law for physical therapy.” Checked October 30, 2026.
9. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). Checked October 30, 2026.
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   “Medicaid covers medically necessary rehabilitative therapy services for beneficiaries of all ages. ... Medicaid beneficiaries under 21 years of age and Healthy Michigan Plan beneficiaries may be eligible for medically necessary habilitative therapy services. ... Medicaid’s standard of coverage for rehabilitative and habilitative therapy allows the following: Outpatient/Private Practice Occupational Therapy ... Up to 144 units of OT per calendar year period. Prior authorization is required for treatment that exceeds this unit limitation. ... Up to 144 units of PT per calendar year period. ... Up to 36 visits of ST per calendar year period.”
10. 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”.
11. PT Compact Commission. PT Compact Map. “Enacted Legislation (3) Maine Michigan Rhode Island ... 3 Enacted Legislation Not Yet Issuing or Accepting Compact Privileges ...” Checked October 30, 2026.
12. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.16187a, Public Health Code (Physical therapy licensure compact). “***** 333.16187a.added THIS ADDED SECTION IS EFFECTIVE JANUARY 22, 2028 ***** ... Physical therapy licensure compact.” Checked October 30, 2026.
13. Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing. Physical Therapy. Checked October 30, 2026.
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    “In July 2026, the Governor signed ... into law, permitting Michigan to begin the process of participating in the Physical Therapy Licensure Compact. Pursuant to the laws’ timelines, the Bureau does not expect the compact’s privilege to practice process to being in Michigan until early 2028.”
14. Occupational Therapy Compact Commission. Before You Apply for an OT Compact Privilege. “State Accepting OT Applications? ... Michigan Not Yet ...” Checked October 30, 2026.
15. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.16188, Public Health Code (Occupational therapy licensure compact). “***** 333.16188.added THIS ADDED SECTION IS EFFECTIVE JANUARY 22, 2028 ***** ... Occupational therapy licensure compact.” Checked October 30, 2026.
16. Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing. Occupational Therapy. Checked October 30, 2026.
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    “In July 2026, the Governor signed ... into law, permitting Michigan to begin the process of participating in the Occupational Therapy Licensure Compact. Pursuant to the laws’ timelines, the Bureau does not expect the compact’s privilege to practice process to begin in Michigan until early 2028.”
17. Audiology and Speech-Language Pathology Interstate Compact Commission. Compact Map. “Active Legislation: 3 ... Michigan HB 4509 ...” Checked October 30, 2026.
18. Michigan Legislature (Legislative Service Bureau). House Bill 4509 of 2025. “(House actions in lowercase, Senate actions in UPPERCASE) ... 10/28/2025 HJ 103 Pg. 1712 passed; given immediate effect Roll Call #269 Yeas 101 Nays 3 Excused 0 Not Voting 6 ... 10/30/2025 SJ 100 Pg. 1700 REFERRED TO COMMITTEE ON HEALTH POLICY ...” Checked October 30, 2026.
19. 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.”.
20. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.16213, Public Health Code. Checked October 30, 2026.
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    “(1) A licensee shall keep and maintain a record for each patient for whom the licensee has provided medical services, including a full and complete record of tests and examinations performed, observations made, and treatments provided. ... (2) Unless a longer retention period is otherwise required under federal or state laws or regulations or by generally accepted standards of medical practice, a licensee shall keep and retain each record required under subsection (1) as follows: (a) Except as otherwise provided in subdivision (b), for a minimum of 7 years from the date of service to which the record pertains. ... (4) Except as otherwise provided in subsection (7), a licensee may destroy a record required under subsection (1) that is less than 7 years old only if both of the following are satisfied: (a) The licensee sends a written notice to the patient at the last known address of that patient informing the patient that the record is about to be destroyed, offering the patient the opportunity to request a copy of that record, and requesting the patient’s written authorization to destroy the record. (b) The licensee receives written authorization from the patient or the patient’s authorized representative agreeing to the destruction of the record.”
21. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). “Therapy providers must retain all applicable documentation in the beneficiary’s medical record for seven years.” Checked October 30, 2026.
22. Michigan Department of Licensing and Regulatory Affairs. Corporations Division. Checked October 30, 2026.
23. Michigan Legislature (Legislative Service Bureau). MCL - Section 450.1284, Business Corporation Act. Checked October 30, 2026.
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    “(1) Except as otherwise provided in subsection (2) or (3), if a professional corporation provides a professional service that is subject to article 15 of the public health code, 1978 PA 368, MCL 333.16101 to 333.18838, each shareholder of the professional corporation must be licensed or legally authorized in this state to provide the same professional service.”
24. Michigan Legislature (Legislative Service Bureau). MCL - Section 450.4904, Michigan Limited Liability Company Act. Checked October 30, 2026.
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    “(2) Except as provided in subsection (3) or (4), if a professional limited liability company renders a professional service that is included within the public health code, 1978 PA 368, MCL 333.1101 to 333.25211, then all members and managers of the company must be licensed or legally authorized in this state to render the same professional service.”
25. Michigan Department of Lifelong Education, Advancement, and Potential. Early On Michigan. Checked October 30, 2026.
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    “Early On is Michigan’s early intervention system for helping infants and toddlers, birth to three years of age who have a disability, developmental delay(s) or are at risk for delay(s) due to certain health conditions, and their families. ... If you think your infant or toddler may have a developmental delay or a pre-existing medical condition, contact Early On at 1-800-EarlyOn (800-327-5966) or complete the online referral form. Early On is offered by the Michigan Department of Lifelong Education, Advancement, and Potential (MiLEAP) as the state lead agency for Part C of the Individuals with Disabilities Education Act (IDEA).”
26. Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing. Physical Therapist Licensing Guide (revision date January 26, 2026). “Online Application for Physical Therapist Renewal – Must be completed by visiting www.michigan.gov/miplus no sooner than 90 days prior to the expiration date of current license. ... Renewal Cycle: 3 years ...” Checked October 30, 2026.
27. Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing. Physical Therapist Licensing Guide (revision date January 26, 2026). Checked October 30, 2026.
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    “Implicit Bias Training – Beginning in 2022, and all renewals thereafter, licensees seeking renewal must have completed a minimum of 1 hour of implicit bias training for each year of the applicant’s license cycle. PDR Credits – Completion of 36 PDR credits during the 3 years immediately preceding the expiration of the license as outlined in Rule 338.7163, and approved by the board as follows: ... No more than 12 PDR credits can be earned during one 24-hour period. ... A minimum of 1 PDR credit must be earned in pain and symptom management.”
28. Michigan Department of Licensing and Regulatory Affairs (Michigan Administrative Code). Michigan Administrative Code, R 338.7138 (Physical Therapy General Rules). Checked October 30, 2026.
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    “(1) A physical therapist who delegates the performance of selected acts, tasks, or functions to a physical therapist assistant as permitted under section 16215 of the code, MCL 333.16215, shall supervise the physical therapist assistant consistent with section 16109(2) of the code, MCL 333.16109, and satisfy the requirements of this rule. ... (b) Examine and evaluate the patient or client before delegating acts, tasks, or functions performed by a physical therapist assistant. (c) Provide predetermined procedures and protocols for delegated acts, tasks, or functions. ... (e) Monitor a physical therapist assistant’s practice and provision of assigned physical therapy acts, tasks, or functions. (f) Meet regularly with the physical therapist assistant to whom acts, tasks, or functions have been delegated to evaluate the assistant’s performance, review records, and educate the physical therapist assistant on the acts, tasks, or functions that have been delegated. (3) A physical therapist shall not supervise more than 4 physical therapist assistants at the same time.”
29. Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing. Occupational Therapist Licensing Guide and FAQs. “Online Application for Occupational Therapist Renewal – Must be completed by visiting www.michigan.gov/miplus no sooner than 90 days prior to the expiration date of current license. ... Renewal Cycle: 2 years ...” Checked October 30, 2026.
30. Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing. Occupational Therapist Licensing Guide and FAQs. Checked October 30, 2026.
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    “During the 2 years preceding the application for renewal, successful completion of 20 hours of continuing education that are approved by the board. A minimum of 1 hour of the required continuing education must be earned in the area of pain and symptom management. ... Implicit Bias Training – Licensees and registrants are required to complete 1 hour of implicit bias training for each year of their license or registration cycle.”
31. Michigan Department of Licensing and Regulatory Affairs (Michigan Administrative Code). Michigan Administrative Code, R 338.1229 (Occupational Therapists General Rules). Checked October 30, 2026.
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    “An occupational therapist who delegates limited assessments, tasks, or interventions to an occupational therapy assistant shall determine and provide the appropriate level of supervision required for the occupational therapy assistant’s performance of the delegated limited assessment, task, or intervention. ... The level of supervision must be either general supervision or direct supervision. ... (b) Complete the evaluation of the patient or client before delegating tasks or interventions to be performed by an occupational therapy assistant. ... (g) Meet in person or using live, synchronous contact at least once per month with the occupational therapy assistant to whom limited assessments, tasks, or interventions have been delegated ... (5) An occupational therapist shall not delegate the performance of either of the following to an occupational therapy assistant: (a) The sole development of a treatment plan. (b) The sole evaluation and interpretation of evaluation results. (6) An occupational therapist shall not supervise more than 4 occupational therapy assistants who are providing services to patients at the same time.”
32. Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing. Michigan Speech Language Pathologist Licensing Guide (revision date January 26, 2026). “Online Application for Speech Language Pathologist Renewal – Must be completed by visiting www.michigan.gov/miplus no sooner than 90 days prior to the expiration date of current license. ... Renewal Cycle: 2 years ...” Checked October 30, 2026.
33. Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing. Michigan Speech Language Pathologist Licensing Guide (revision date January 26, 2026). Checked October 30, 2026.
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    “Implicit Bias Training – Licensees and registrants are required to complete 1 hour of implicit bias training for each year of their license or registration cycle. ... you have met all of the following continuing education requirements during the 2-year period immediately preceding the application for renewal: ... Proof of 20 hours of continuing professional development courses are required to be submitted, including 1 hour in pain and/or symptom management.”
34. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.16215, Public Health Code. Checked October 30, 2026.
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    “(1) Subject to subsections (2) to (6), a licensee who holds a license other than a health profession subfield license may delegate to a licensed or unlicensed individual who is otherwise qualified by education, training, or experience the performance of selected acts, tasks, or functions where the acts, tasks, or functions fall within the scope of practice of the licensee’s profession and will be performed under the licensee’s supervision. A licensee shall not delegate an act, task, or function under this section if the act, task, or function, under standards of acceptable and prevailing practice, requires the level of education, skill, and judgment required of the licensee under this article.”
35. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.18301, Public Health Code. Checked October 30, 2026.
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    “(b) "Occupational therapist" means an individual licensed under this article to engage in the practice of occupational therapy. ... (iii) Evaluation of factors that affect activities of daily living, instrumental activities of daily living, and other activities relating to education, work, play, leisure, and social participation. ... (K) Providing vision therapy services or low vision rehabilitation services, if those services are provided pursuant to a referral or prescription from, or under the supervision or comanagement of, a physician licensed under part 170 or 175 or an optometrist licensed under part 174.”
36. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.18303, Public Health Code. Checked October 30, 2026.
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    “(2) After the rules described in sections 18307 and 18309 are promulgated for licensure under this part, an individual shall not engage in the practice of occupational therapy or the practice as an occupational therapy assistant unless licensed or otherwise authorized by this article.”
37. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). “Outpatient hospital, private practice, and nursing facility therapy requires a prescription from a physician or other licensed practitioner practicing within their scope of practice as defined in State law for occupational therapy.” Checked October 30, 2026.
38. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.17607, Public Health Code. Checked October 30, 2026.
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    “(3) A licensee shall perform assessment, treatment or therapy, and procedures related to swallowing disorders and medically related communication disorders only on patients who have been referred to him or her by an individual licensed in the practice of medicine or osteopathic medicine and surgery or by an advanced practice registered nurse as that term is defined in section 17201.”
39. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.17607, Public Health Code. Checked October 30, 2026.
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    “A speech-language pathologist shall refer a patient to an individual licensed in the practice of medicine or osteopathic medicine and surgery if signs or symptoms identified during the practice of speech-language pathology cause the speech-language pathologist to suspect that the patient has an underlying medical condition.”
40. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). “Outpatient hospital, private practice, and nursing facility therapy requires a prescription from a physician or other licensed practitioner practicing within their scope of practice as defined in State law for speech-language therapy.” Checked October 30, 2026.
41. Michigan Department of Health and Human Services. Provider Enrollment. Checked October 30, 2026.
42. 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.”.
43. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). Checked October 30, 2026.
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    “Outpatient/ Private Practice Therapy PA is needed when therapy limits are exceeded regardless of diagnosis. Continued therapy may be authorized for periods not to exceed six months. ... Providers are encouraged to submit PA requests electronically through direct data entry (DDE) in CHAMPS via the CHAMPS Provider Portal (refer to the Directory Appendix for website information) whenever possible. ... Providers unable to submit authorization requests electronically may send requests to the MDHHS Program Review Division using the Occupational Therapy-Physical Therapy-Speech Therapy Prior Authorization Request (revised per bulletin MMP 26-02) (MSA-115).”
44. Michigan Department of Health and Human Services. Medicaid Provider Manual, Medicaid Health Plans chapter (version date October 1, 2026). Checked October 30, 2026.
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    “The Michigan Department of Health and Human Services (MDHHS) contracts with Medicaid Health Plans (MHPs), selected through a competitive bid process, to provide services to Medicaid beneficiaries. ... MHPs are allowed to develop prior authorization requirements and utilization management review criteria that differ from Medicaid requirements. ... The following services must be covered by MHPs: ... Therapies (speech, language, physical, occupational)”
45. Michigan Department of Health and Human Services. Medicaid Provider Manual, Billing & Reimbursement for Professionals chapter (version date October 1, 2026). “For MHP enrollees, the provider should check with the MHP for PA requirements.” Checked October 30, 2026.
46. Michigan Department of Health and Human Services. Therapies. Checked October 30, 2026.
47. Michigan Department of Health and Human Services. Medicaid Provider Manual, Billing & Reimbursement for Professionals chapter (version date October 1, 2026). Checked October 30, 2026.
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    “Every therapy service must have an appropriate therapy modifier reported on the service line to distinguish the plan of care under which the service is delivered. When the therapy is habilitative in nature, services must be billed modifier 96. Maintenance therapy must also be reported with modifier TS. ... 97 Rehabilitative Service Used to identify therapy services rehabilitative in nature. GP Service delivered under an outpatient physical therapy plan of care. ... GO Service delivered under an outpatient occupational therapy plan of care. ... GN Service delivered under an outpatient speech-language pathology plan of care.”
48. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). Checked October 30, 2026.
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    “Students, graduates, educational limited temporary licensed therapists, and assistants are not eligible to enroll or be directly reimbursed by Medicaid. Services performed by these individuals are required to be reported under the National Provider Identifier (NPI) of the supervising therapist.”
49. Michigan Department of Health and Human Services. Medicaid Provider Manual, Telemedicine chapter (version date October 1, 2026). “Modifier 95 should be used in addition to the required modifiers for therapy services as outlined in therapy policy.” Checked October 30, 2026.
50. Michigan Department of Health and Human Services. Medicaid Provider Manual, School Services Program chapter (version date October 1, 2026). Checked October 30, 2026.
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    “This chapter applies to enrolled Intermediate School Districts (ISDs) and their associated local education agencies (LEAs), Detroit Public Schools Community District (DPSCD), and Michigan School for the Deaf (MSD). This chapter describes the coverage and reimbursement policy for direct medical services, targeted case management (TCM), and personal care services (PCS). Coverage applies to individuals up to the age of 21 who are eligible under the provisions of the Individuals with Disabilities Education Act (IDEA) of 1990 as amended in 2004 and to those enrolled in programs that require an Individualized Education Program (IEP) or an Individualized Family Service Plan (IFSP)”
51. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). Checked October 30, 2026.
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    “Medicaid does not require a school-aged beneficiary to be referred to or access therapy services through the School Services Program (SSP) benefit prior to, or in lieu of, accessing medically based therapy in the community. ... If therapy is provided in more than one setting, the goals and purpose for each must be distinct.”
52. Michigan Department of Health and Human Services. Medicaid Provider Manual, Telemedicine chapter (version date October 1, 2026). Checked October 30, 2026.
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    “MDHHS will allow select therapy services to be provided via telemedicine when performed by Medicaid-enrolled private practice and outpatient hospital physical therapy (PT), occupational therapy (OT) and speech therapy (ST) providers. ... Initial PT and OT evaluations and oral motor/swallowing services are not allowed via telemedicine and should be provided in-person. ... All telemedicine therapy services will count toward the beneficiary’s therapy service limits.”
53. Michigan Legislature (Legislative Service Bureau). MCL - Section 333.16284, Public Health Code. “Except as otherwise provided in this section, a health professional shall not provide a telehealth service without directly or indirectly obtaining consent for treatment.” Checked October 30, 2026.
54. Michigan Department of Licensing and Regulatory Affairs (Michigan Administrative Code). Michigan Administrative Code, R 338.1241 (Occupational Therapists General Rules). Checked October 30, 2026.
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    “(2) If the patient is less than 18 years of age, or under the care of a legal guardian, a parent or legal guardian shall provide consent for the telehealth service. (3) A licensee shall keep proof of consent for a telehealth treatment in the patient’s up-to-date medical record in compliance with section 16213 of the code, MCL 333.16213.”
55. Michigan Department of Licensing and Regulatory Affairs (Michigan Administrative Code). Michigan Administrative Code, R 338.7127 (Physical Therapy General Rules). Checked October 30, 2026.
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    “(1) A licensee shall obtain consent for treatment before providing a telehealth service under section 16284 of the code, MCL 333.16284. (2) A licensee shall keep proof of consent for telehealth treatment in the patient’s up-to-date medical record and follow section 16213 of the code, MCL 333.16213. (3) A licensee providing any telehealth service shall do both of the following: (a) Act within the scope of the licensee’s practice. (b) Exercise the same standard of care applicable to a traditional, in-person health care service.”
56. Michigan Department of Licensing and Regulatory Affairs (Michigan Administrative Code). Michigan Administrative Code, R 338.643 (Speech-Language Pathology General Rules). Checked October 30, 2026.
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    “(1) A licensee shall obtain consent for treatment before providing a telehealth service under section 16284 of the code, MCL 333.16284. (2) A licensee shall keep proof of consent for telehealth treatment in the patient’s up-to-date medical record and satisfy section 16213 of the code, MCL 333.16213. (3) A licensee providing any telehealth service shall do both of the following: (a) Act within the scope of the licensee’s practice. (b) Exercise the same standard of care applicable to a traditional, in-person healthcare service.”
57. Michigan Legislature (Legislative Service Bureau). MCL - Section 500.3476, The Insurance Code of 1956. Checked October 30, 2026.
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    “(1) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall not require face-to-face contact between a health care professional and a patient for services appropriately provided through telemedicine, as determined by the insurer. ... Telemedicine services must be provided by a health care professional who is licensed, registered, or otherwise authorized to engage in the health care professional’s health care profession in the state where the patient is located. Telemedicine services are subject to all terms and conditions of the health insurance policy agreed on between the policy holder and the insurer, including, but not limited to, required copayments, coinsurances, deductibles, and approved amounts.”
58. Michigan Legislature (Legislative Service Bureau). MCL - Section 550.1401k, Nonprofit Health Care Corporation Reform Act. Checked October 30, 2026.
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    “(1) A group or nongroup health care corporation certificate must not require face-to-face contact between a health care professional and a patient for services appropriately provided through telemedicine, as determined by the health care corporation. Telemedicine services must be provided by a health care professional who is licensed, registered, or otherwise authorized to engage in his or her health care profession in the state where the patient is located.”
59. Michigan Department of Treasury. Online Business Registration. Checked October 30, 2026.
60. Michigan Department of Treasury. Sales and Use Taxes. “Individuals or businesses that sell tangible personal property to the final consumer are required to remit a 6% sales tax on the total price of their taxable retail sales to the State of Michigan.” Checked October 30, 2026.
61. Michigan Legislature (Legislative Service Bureau). MCL - Section 205.52, General Sales Tax Act. Checked October 30, 2026.
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    “(1) Except as provided in section 2a, there is levied upon and there shall be collected from all persons engaged in the business of making sales at retail, by which ownership of tangible personal property is transferred for consideration, an annual tax for the privilege of engaging in that business equal to 6% of the gross proceeds of the business ...”
62. Michigan Legislature (Legislative Service Bureau). MCL - Section 205.54a, General Sales Tax Act. “(1) Subject to subsection (2), the following are exempt from the tax under this act: ... (k) The sale of a prosthetic device, durable medical equipment, or mobility enhancing equipment.” Checked October 30, 2026.
63. Michigan Legislature (Legislative Service Bureau). MCL - Section 418.115, Worker’s Disability Compensation Act of 1969. Checked October 30, 2026.
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    “This act shall apply to: (a) All private employers, other than agricultural employers, who regularly employ 3 or more employees at 1 time. (b) All private employers, other than agricultural employers, who regularly employ less than 3 employees if at least 1 of them has been regularly employed by that same employer for 35 or more hours per week for 13 weeks or longer during the preceding 52 weeks.”
64. Michigan Legislature (Legislative Service Bureau). MCL - Section 418.611, Worker’s Disability Compensation Act of 1969. Checked October 30, 2026.
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    “(1) Each employer under this act, subject to the approval of the director, shall secure the payment of compensation under this act by either of the following methods: (a) By receiving authorization from the director to be a self-insurer. ... (b) By insuring against liability with an insurer authorized to transact the business of worker’s compensation insurance within this state.”
65. 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.”.
66. 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.”.
67. Michigan Legislature (Legislative Service Bureau). MCL - Section 445.72, Identity Theft Protection Act. Checked October 30, 2026.
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    “(1) Unless the person or agency determines that the security breach has not or is not likely to cause substantial loss or injury to, or result in identity theft with respect to, 1 or more residents of this state, a person or agency that owns or licenses data that are included in a database that discovers a security breach, or receives notice of a security breach under subsection (2), shall provide a notice of the security breach to each resident of this state who meets 1 or more of the following: (a) That resident’s unencrypted and unredacted personal information was accessed and acquired by an unauthorized person. ... (4) A person or agency shall provide any notice required under this section without unreasonable delay.”
68. Michigan Legislature (Legislative Service Bureau). MCL - Section 722.623, Child Protection Law. Checked October 30, 2026.
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    “(a) A physician, dentist, physician’s assistant, registered dental hygienist, medical examiner, nurse, person licensed to provide emergency medical care, audiologist, psychologist, physical therapist, physical therapist assistant, occupational therapist, athletic trainer, marriage and family therapist, licensed professional counselor, social worker, licensed master’s social worker, licensed bachelor’s social worker, registered social service technician, social service technician, a person employed in a professional capacity in any office of the friend of the court, school administrator, school counselor or teacher, law enforcement officer, member of the clergy, or regulated child care provider who has reasonable cause to suspect child abuse or child neglect shall make an immediate report to centralized intake by telephone, or, if available, through the online reporting system, of the suspected child abuse or child neglect. Within 72 hours after making an oral report by telephone to centralized intake, the reporting person shall file a written report as required in this act.”
69. Michigan Legislature (Legislative Service Bureau). MCL - Section 500.3406s, The Insurance Code of 1956. Checked October 30, 2026.
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    “(1) Except as otherwise provided in this section, an insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall provide coverage for the diagnosis of autism spectrum disorders and treatment of autism spectrum disorders. An insurer shall not do any of the following: ... (b) Limit the number of visits an insured or enrollee may use for treatment of autism spectrum disorders covered under this section. (c) Deny or limit coverage under this section on the basis that treatment is educational or habilitative in nature. ... An insurer may limit coverage under this section for treatment of autism spectrum disorders to an insured or enrollee through 18 years of age and may subject the coverage to a maximum annual benefit as follows: (i) For a covered insured or enrollee through 6 years of age, $50,000.00. (ii) For a covered insured or enrollee from 7 years of age through 12 years of age, $40,000.00. (iii) For a covered insured or enrollee from 13 years of age through 18 years of age, $30,000.00. ... (j) "Therapeutic care" means evidence-based services provided by a licensed or certified speech therapist, occupational therapist, physical therapist, or social worker. (k) "Treatment of autism spectrum disorders" means evidence-based treatment that includes the following care prescribed 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: ... (v) Therapeutic care.”
70. Michigan Department of Health and Human Services. General Information For Families About "Children’s Special Health Care Services" (CSHCS). Checked October 30, 2026.
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    “Children’s Special Health Care Services (CSHCS) is a program within the Michigan Department of Health and Human Services. It is for children and some adults with special health care needs and their families. ... Coverage for care and treatment related to the qualifying diagnosis ... CSHCS covers more than 2,700 physical conditions when certain criteria are met. NOTE: CSHCS does not cover developmental, behavioral or intellectual conditions. ... Clients must be under the age of 26.”
71. Michigan Department of Health and Human Services. Medicaid Provider Manual, Therapy Services chapter (version date October 1, 2026). Checked October 30, 2026.
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    “The primary objective of the Children’s Special Health Care Services (CSHCS) Program is to ensure that CSHCS beneficiaries receive medically necessary services related to a CSHCS qualifying diagnosis as recommended by a CSHCS authorized subspecialist. ... Home Health speech therapy is only covered for CSHCS beneficiaries and requires PA for visits beyond initial evaluation.”
72. Centers for Medicare & Medicaid Services. Medicare Administrative Contractors (MACs). “MAC Jurisdiction Processes Part A & Part B Claims for the following states/territories: MAC ... 8 Indiana, Michigan Wisconsin Physicians Service Government Health Administrators ...” Checked October 30, 2026.
73. Michigan Department of Labor and Economic Opportunity, Workers’ Disability Compensation Agency. 2025 Rules Manual and Fees. Checked October 30, 2026.
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    “The Health Care Services cost containment calculations for the 2025 Rule Set are posted below. The boxes below address the seven different methods of calculation used to determine the maximum allowable payment (MAP) for medical care, treatment, procedures and devices under the Michigan Workers’ Disability Compensation Act and the Health Care Services Rules.”
74. Michigan Department of Labor and Economic Opportunity, Workers’ Disability Compensation Agency (Michigan Administrative Code). Workers’ Compensation Health Care Services rules, R 418.10212. Checked October 30, 2026.
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    “Physical therapy means physical treatment provided by a licensed physical therapist. Occupational therapy means physical treatment provided by an occupational therapist. ... (3) Any of the following may provide physical treatment, to the extent that licensure, registration, or certification law allows: ... (f) A physical therapist. (g) An occupational therapist. (4) Only a licensed physical therapist, licensed occupational therapist, or licensed practitioner may use procedure codes 97161-97168 to describe the physical medicine and rehabilitation evaluation services.”
75. APTA Michigan. APTA Michigan (the state association's site). Checked October 30, 2026.
76. the Michigan Occupational Therapy Association. the Michigan Occupational Therapy Association (the state association's site). Checked October 30, 2026.
77. the Michigan Speech Language Hearing Association. the Michigan Speech Language Hearing Association (the state association's site). Checked October 30, 2026.
78. DrSensory. Occupational therapy clinics in Michigan, 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.
79. 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 Michigan, not legal, compliance, billing or financial advice. Rules change; the clinic confirms each with its source before acting on it.