New York therapy practice guide: PT, OT and SLP

For OT, PT and SLP clinics in New York: one office licenses all three disciplines; a patient may see a physical therapist with three years of practice without a referral for 10 visits or 30 days, whichever comes first; New York State Medicaid covers children’s therapy under EPSDT and adults within its own rules; and telehealth follows the patient’s location.⁠^1,2,3,4

Who licenses OTs, PTs and SLPs in New York?

The New York State Education Department’s Office of the Professions licenses all three disciplines, and each profession has its own statute and continuing-education requirement.⁠^1,5,6 A clinic that employs more than one discipline still keeps three registers, not one.

Physical therapists, occupational therapists and speech-language pathologists all answer to the New York State Education Department’s Office of the Professions, each profession under its own statute and continuing-education rule. Within it, each profession has its own state board: the New York State Board for Physical Therapy, the New York State Board for Occupational Therapy and the New York State Board for Speech-Language Pathology and Audiology.⁠^1,5,6 A license is a state authorization; a national certification (NBCOT for occupational therapy, the ASHA certificate for speech-language pathology, the NPTE for physical therapy) is a different thing and does not replace it. Compact privileges for practitioners licensed elsewhere are covered under telehealth below.

What does a New York license renewal require?

The office sets the cycle and hours for each profession, listed in the table above, and the register template at the end of this page tracks them per clinician.⁠^1,5,6 A renewal missed is a lapse, and the office’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 New York 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 with at least three years of full-time practice may treat a patient without a referral for ten visits or thirty days, whichever comes first, after giving the patient written notice that insurance may not cover treatment without a referral; other treatment is rendered on the referral of a physician, dentist, podiatrist, nurse practitioner or licensed midwife, and New York Medicaid requires a written order from a physician, physician assistant or nurse practitioner.⁠^2,7 For occupational therapy, a treatment program to restore function is rendered on the prescription or referral of a physician, nurse practitioner or other authorized provider, except that an occupational therapist with at least three years of full-time practice may treat without a referral for ten visits or thirty days, whichever comes first, after giving the patient written notice that insurance may not cover it; New York Medicaid requires a written order from a physician, physician assistant or nurse practitioner.⁠^40,41 For speech-language pathology, the act defines speech-language pathology to include non-medical diagnosis, testing and rehabilitation and requires a license to practice, and it does not condition practice on a referral; New York Medicaid pays for speech therapy on a written order from a physician, physician assistant or nurse practitioner, or a written referral from a speech-language pathologist.⁠^42,43,44

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.⁠¹³ New York State 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 New York State Medicaid pay for pediatric and adult therapy?

New York State Medicaid is run by the New York State Department of Health, and a clinic enrolls through its provider enrollment route before it bills.⁠⁴⁵ 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.⁠⁴⁶ New York Medicaid meets the federal EPSDT requirements through the Child/Teen Health Program for members from birth to age 21, and the managed care model contract’s 20-visit therapy limits do not apply to enrollees under 21.⁠^3,4

The Medicaid managed care model contract covers outpatient physical, occupational and speech therapy for adults up to 20 visits each per calendar year, a limit that does not apply to enrollees who are developmentally disabled or who have a traumatic brain injury.⁠⁸ New York Medicaid’s rehabilitation fee schedule requires a written order from a physician, physician assistant or nurse practitioner for therapy, and accepts a written referral from a speech-language pathologist for speech therapy.⁠⁴⁷ New York Medicaid members choose a Medicaid managed care health plan, and the plans pay network providers directly.⁠^48,49 The fee schedule is published by the agency, and a clinic reads the current file rather than a remembered rate.⁠⁵⁰

How does New York State Medicaid want OT, PT and SLP claims coded?

New York Medicaid therapy claims carry modifier GP, GO or GN for the discipline’s plan of care (ST for a patient with a traumatic brain injury). Physical and occupational therapy bill in 15-minute units and speech therapy in half-hour units. The fee schedule applies to private office settings, and in any other setting, such as a diagnostic and treatment center, a hospital outpatient department or a nursing home, the therapist cannot bill Medicaid directly and is paid by the institution.⁠^{51,52,53,54,55,56,57} 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 New York State Medicaid pay for therapy in schools?

The Preschool/School Supportive Health Services Program, run jointly by the State Education Department and the Department of Health, reimburses school districts, 4201 schools and counties for physical, occupational and speech therapy for Medicaid-eligible students with disabilities from age three to their 21st birthday.⁠⁵⁸ 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 New York State Medicaid cover therapy by telehealth?

New York Medicaid’s telehealth policy manual lists speech-language pathologists, physical therapists and occupational therapists among the telehealth providers defined in Public Health Law section 2999-cc.⁠⁵⁹ The telehealth section below covers the state’s own rules for the session itself.

What are New York’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.⁠⁹ Public Health Law section 2999-cc names licensed physical therapists, occupational therapists and speech-language pathologists as telehealth providers. New York Medicaid’s telehealth manual does not require written consent, but the provider must document informed consent in the chart before or during the first telehealth visit.⁠^60,61

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.⁠¹⁰ Insurance Law section 3217-h bars an insurer from excluding a covered service because it is delivered by telehealth, and until April 1, 2028 requires an insurer with comprehensive coverage to reimburse covered telehealth services at the same rate as in-person services.⁠^62,63

Which business steps are specific to New York?

The entity is registered with the New York Department of State, and the choice of entity is shaped by the state’s rule on who may own a therapy business. Licensed physical therapists, occupational therapists and speech-language pathologists may form a professional service corporation under Business Corporation Law Article 15 or a professional service limited liability company under Limited Liability Company Law Article 12, owned by those licensed to render the same professional service. The State Education Department says a general business corporation may not offer occupational therapy to the public.⁠^17,18,19,20 State tax registration is with the New York State Department of Labor, for an employer’s unemployment insurance registration.⁠^64,65 New York’s sales tax applies only to certain services, such as information, repair, storage and protective services. Sales of medical equipment and supplies are exempt unless sold for use in providing medical or similar services for compensation, and prosthetic aids, hearing aids and eyeglasses are exempt.⁠^66,67 Every employer subject to the Workers’ Compensation Law must secure compensation for its employees and pay or provide compensation for disability or death from injury arising out of and in the course of employment, without regard to fault.⁠⁶⁸ 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 New York?

The Rules of the Board of Regents make it unprofessional conduct for a licensed physical therapist, occupational therapist or speech-language pathologist not to keep a record for each patient. Records must be kept at least six years, and a minor’s records at least six years and until one year after the patient turns 21. New York Medicaid requires its members’ records kept six years from the date of payment.⁠^14,15,16 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.⁠^69,70

The Rules of the Board of Regents make it unprofessional conduct for any licensed professional to reveal personally identifiable information obtained in a professional capacity without the patient’s prior consent, except as the law authorizes or requires.⁠⁷¹ General Business Law section 899-aa requires a business that owns or licenses computerized private information to notify affected New York residents of a security breach without unreasonable delay and within thirty days of discovery, except for the legitimate needs of law enforcement.⁠⁷² Social Services Law section 413 requires listed professionals and officials to report suspected child abuse or maltreatment, including hospital personnel engaged in the care or treatment of persons and school personnel required to hold a teaching or administrative license or certificate.⁠⁷³

Which New York rules shape a pediatric clinic?

New York’s Early Intervention Program serves children under age 3 with a confirmed disability or established developmental delay, and its services include occupational therapy, physical therapy and speech pathology. Child health care providers must refer a child suspected of having or at risk of a disability to the county’s early intervention official within two working days, unless the parent objects.⁠^21,22,23 A child who turns three moves from early intervention to the school district’s evaluation, and a private clinic’s services run beside both systems rather than inside them. Insurance Law section 3216 requires a policy with comprehensive-type coverage to cover screening, diagnosis and treatment of autism spectrum disorder, including speech, occupational and physical therapy (habilitative or nonrestorative care too, when the policy covers therapeutic care), with no visit limits applied solely to autism treatment. Coverage may be denied for treatment provided under an individualized education plan.⁠⁷⁴ The autism insurance mandates guide covers how such a mandate meets a plan’s own terms.

Which New York rules shape an adult clinic?

Medicare claims from New York go to National Government Services, the Medicare Administrative Contractor for Jurisdiction K, Parts A and B (Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont), whose local coverage articles for therapy are the ones a New York clinic reads.⁠⁷⁵ New York State Medicaid’s adult therapy rules are in the Medicaid section above. The Workers’ Compensation Board pays health care providers by set medical fee schedules, including an Acupuncture and Physical & Occupational Therapy fee schedule, which is purchased from RefMed or viewed in person.⁠⁷⁶

Which associations and directory pages serve New York?

The state chapters are APTA New York for physical therapy, the New York State Occupational Therapy Association for occupational therapy and the New York State Speech-Language-Hearing Association for speech-language pathology.⁠^77,78,79 On DrSensory, families browse New York 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.⁠⁸⁰

Which New York cities have DrSensory city pages?

Beyond its three New York pages, the directory publishes city pages for 4 New York 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.⁠⁸⁰

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

DrSensory lists 166 PT, OT and SLP clinics in New York, on its occupational therapy, physical therapy and speech therapy pages for the state.⁠⁸⁰

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

Which templates does a New York launch need?

How might two New York clinics plan a launch?

Sources

1. New York State Education Department, Office of the Professions. New York State Board for Physical Therapy (New York State Education Department, Office of the Professions). Checked October 30, 2026.
2. New York State Senate (NYS Open Legislation). Education Law section 6731, Definition of physical therapy. Checked October 30, 2026.
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   “Such treatment may be rendered by a licensed physical therapist for ten visits or thirty days, whichever shall occur first, without a referral from a physician, dentist, podiatrist, nurse practitioner or licensed midwife provided that: (1) The licensed physical therapist has practiced physical therapy on a full time basis equivalent to not less than three years. (2) Each physical therapist licensed pursuant to this article shall provide written notice to each patient receiving treatment absent a referral from a physician, dentist, podiatrist, nurse practitioner or licensed midwife that physical therapy may not be covered by the patient’s health care plan or insurer without such a referral and that such treatment may be a covered expense if rendered pursuant to a referral.”
3. New York State Department of Health. Information for All Providers, General Policy (Version 2022-2). “New York State’s Medicaid Program (Child Health Plus A) implements federal EPSDT requirements via the Child/Teen Health Program (CTHP). ... The CTHP includes a full range of comprehensive, primary health care services for Medicaid-eligible youth from birth until age 21.” Checked October 30, 2026.
4. New York State Department of Health. Medicaid Managed Care / Family Health Plus / HIV Special Needs Plan / Health and Recovery Plan Model Contract (March 1, 2024). Checked October 30, 2026.
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   “Outpatient physical, occupational and speech therapy limited to 20 visits each per calendar year. Limits do not apply to Enrollees under age 21, Enrollees who are developmentally disabled, and Enrollees with traumatic brain injury.”
5. New York State Education Department, Office of the Professions. New York State Board for Occupational Therapy (New York State Education Department, Office of the Professions). Checked October 30, 2026.
6. New York State Education Department, Office of the Professions. New York State Board for Speech-Language Pathology and Audiology (New York State Education Department, Office of the Professions). Checked October 30, 2026.
7. New York State Department of Health. Rehabilitation Services Manual Policy Guidelines (Version 2024-1). “Rehabilitation services must be ordered, in writing, by a physician, physician assistant, or nurse practitioner so authorized by law.” Checked October 30, 2026.
8. New York State Department of Health. Medicaid Managed Care / Family Health Plus / HIV Special Needs Plan / Health and Recovery Plan Model Contract (March 1, 2024). Checked October 30, 2026.
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   “Outpatient physical, occupational and speech therapy limited to 20 visits each per calendar year. Limits do not apply to Enrollees under age 21, Enrollees who are developmentally disabled, and Enrollees with traumatic brain injury.”
9. 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”.
10. PT Compact Commission. PT Compact Map. “Non-Members (10) California Florida Hawaii Idaho Minnesota New Mexico New York ...” Checked October 30, 2026.
11. 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.
12. Audiology and Speech-Language Pathology Interstate Compact Commission. Delegate Information. Checked October 30, 2026.
13. 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.”.
14. New York State Education Department, Office of the Professions. Rules of the Board of Regents, Part 29, section 29.2. Checked October 30, 2026.
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    “failing to maintain a record for each patient which accurately reflects the evaluation and treatment of the patient. Unless otherwise provided by law, all patient records must be retained for at least six years. Obstetrical records and records of minor patients must be retained for at least six years, and until one year after the minor patient reaches the age of 21 years ...”
15. New York State Education Department, Office of the Professions. Rules of the Board of Regents, Part 29, section 29.2. “Unprofessional conduct shall also include, in the professions of: ... occupational therapy, occupational therapy assistant, ... physical therapist assistant, physical therapy, ... speech-language pathology ...” Checked October 30, 2026.
16. New York State Department of Health. Information for All Providers, General Policy (Version 2022-2). “For auditing purposes, records on enrollees must be maintained and be available to authorized Medicaid officials for six years following the date of payment.” Checked October 30, 2026.
17. New York State Senate (NYS Open Legislation). Business Corporation Law section 1503, Organization. Checked October 30, 2026.
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    “(a) Notwithstanding any other provision of law, one or more individuals duly authorized by law to render the same professional service within the state may organize, or cause to be organized, a professional service corporation for pecuniary profit under this article for the purpose of rendering the same professional service ...”
18. New York State Senate (NYS Open Legislation). Limited Liability Company Law section 1203, Formation. Checked October 30, 2026.
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    “(a) Notwithstanding the education law or any other provision of law, one or more professionals each of whom is authorized by law to render a professional service within the state, or one or more professionals, at least one of whom is authorized by law to render a professional service within the state, may form, or cause to be formed, a professional service limited liability company for pecuniary profit under this article for the purpose of rendering the professional service or services as such professionals are authorized to practice.”
19. New York State Education Department, Office of the Professions. Corporate Entities for Professional Practice, Section I. Checked October 30, 2026.
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    “Although the Certificates of Incorporation of such corporations are filed with the Department of State, Articles 15 and 15-A place certain responsibilities with the "licensing authority" which, in the case of the following professions, is the Regents of the University of the State of New York through the State Education Department. Health Services Professions ... Occupational Therapy Occupational Therapy Assistant ... Physical Therapy Physical Therapist Assistant ... Speech-Language Pathology ...”
20. New York State Education Department, Office of the Professions. Frequently Asked Questions for Occupational Therapists - Practice Issues. Checked October 30, 2026.
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    “Only a person licensed or otherwise exempt may practice occupational therapy or use the title "occupational therapist." There is no exemption for a general business corporation to either use the title "occupational therapist" or practice occupational therapy. In as much as a general business corporation acts through its employees, no employee of a general business corporation may offer occupational therapy services to the public or hold out as practicing occupational therapy.”
21. New York State Department of Health. Early Intervention Program (revised November 2025). Checked October 30, 2026.
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    “To be eligible for services, children must be under 3 years of age and have a confirmed disability or established developmental delay, as defined by the State, in one or more of the following areas of development: physical, cognitive, communication, social-emotional, and/or adaptive. ... The Early Intervention Program offers a variety of therapeutic and support services to eligible infants and toddlers with disabilities and their families, including: ... occupational therapy physical therapy ... speech pathology ...”
22. New York State Senate (NYS Open Legislation). Public Health Law section 2542, Comprehensive child find system and public awareness program. Checked October 30, 2026.
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    “3. The following persons and entities, within two working days of identifying an infant or toddler suspected of having a disability or at risk of having a disability, shall refer such infant or toddler to the early intervention official or the health officer of the public health district in which the infant or toddler resides, as designated by the municipality, but in no event over the objection of the parent made in accordance with procedures established by the department for use by such primary referral sources, unless the child has already been referred: hospitals, child health care providers, day care programs, local school districts, public health facilities, early childhood direction centers and such other social service and health care agencies and providers as the commissioner shall specify in regulation ...”
23. New York State Department of Health. Early Intervention Program (revised November 2025). “A municipal Early Intervention Official (EIO) designated by the chief elected official of the municipality/county administers the Early Intervention Program locally. Contact your EIO for information about your local program or to refer a child.” Checked October 30, 2026.
24. New York State Education Department, Office of the Professions. Education Law section 6742-a. “Each licensed physical therapist and licensed physical therapist assistant required under this article to register triennially with the department to practice in the state shall comply with the provisions of the mandatory continuing education requirements ...” Checked October 30, 2026.
25. New York State Senate (NYS Open Legislation). Education Law section 6502, Duration and registration of a license. Checked October 30, 2026.
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    “A license shall be valid during the life of the holder unless revoked, annulled or suspended by the board of regents ... A licensee must register with the department and meet the requirements prescribed in section 3-503 of the general obligations law to practice in this state.”
26. New York State Education Department, Office of the Professions. Continuing Education for Physical Therapists (last updated October 21, 2009). “On July 7, 2008, Chapter 207 of the Laws of 2008, requiring physical therapists and physical therapist assistants to complete thirty-six hours of continuing education during each three-year registration renewal period, was signed into law.” Checked October 30, 2026.
27. New York State Education Department, Office of the Professions. Education Law section 6738. Checked October 30, 2026.
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    “A "physical therapist assistant" means a person licensed in accordance with this article who works under the supervision of a licensed physical therapist performing such patient related activities as are assigned by the supervising physical therapist. Duties of physical therapist assistants shall not include evaluation, testing, interpretation, planning or modification of patient programs. Supervision of a physical therapist assistant by a licensed physical therapist shall be on-site supervision, but not necessarily direct personal supervision. The number of licensed physical therapist assistants supervised by one licensed physical therapist shall not exceed the ratio of four licensed physical therapist assistants to one licensed physical therapist ...”
28. New York State Education Department, Office of the Professions. Frequently Asked Practice Questions (last updated January 12, 2012). Checked October 30, 2026.
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    “Supervision of a physical therapist assistant by a physical therapist must be on site, that is, in the same building, but not necessarily direct personal supervision, that is, in the same room. For patients on a maintenance care program in residential health care facilities or certain other sites defined by the mental hygiene law, supervision of the physical therapist assistant by the physical therapist must be continuous but not necessarily on site. Continuous but not necessarily on site supervision is also required in home care services settings and in schools. In general one physical therapist may supervise no more than four physical therapist assistants. In a home care services setting, a physical therapist may supervise no more than two physical therapist assistants.”
29. New York State Education Department, Office of the Professions. Education Law section 6738. Checked October 30, 2026.
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    “For the purposes of the provision of physical therapist assistant services in a home care services setting, as such services are defined in article thirty-six of the public health law, ... continuous supervision of a licensed physical therapist assistant, who has had direct clinical experience for a period of not less than two years, by a licensed physical therapist shall not be construed as requiring the physical presence of such licensed physical therapist at the time and place where such services are performed. ... For purposes of the provision of licensed physical therapist assistant services in public primary or private primary or secondary schools and for preschool children, ... continuous supervision of a licensed physical therapist assistant, who has direct clinical experience providing age appropriate physical therapy services for a period of not less than two years, by a licensed physical therapist shall not be construed as requiring the physical presence of such licensed physical therapist at the time and place where such services are performed.”
30. New York State Education Department, Office of the Professions. Continuing Competency for Occupational Therapists and Occupational Therapy Assistants. “Your professional license is valid for life. However, registrations are valid for 3 years. In most cases, the State Education Department will reissue your registration only if you have completed 36 hours of continuing competency learning activities.” Checked October 30, 2026.
31. New York State Senate (NYS Open Legislation). Education Law section 6502, Duration and registration of a license. Checked October 30, 2026.
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    “A license shall be valid during the life of the holder unless revoked, annulled or suspended by the board of regents ... A licensee must register with the department and meet the requirements prescribed in section 3-503 of the general obligations law to practice in this state.”
32. New York State Education Department, Office of the Professions. Continuing Competency for Occupational Therapists and Occupational Therapy Assistants. Checked October 30, 2026.
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    “Most New York State licensed and registered occupational therapists and occupational therapy assistants (licensees) must complete 36 hours of continuing competency learning activities during every 3-year registration cycle. Please note, only two-thirds of the requirement can be met through self-directed online study from an approved provider, the other one-third must be in-person, live online, or synchronous online study from an approved provider or other learning activities as defined below. At least 24 hours of the continuing competency learning activities must focus on professional subjects (subjects that contribute to competent occupational therapy practice.)”
33. New York State Education Department, Office of the Professions. Education Law section 7902-a. Checked October 30, 2026.
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    “Only a person licensed or otherwise authorized under this title shall participate in the practice of occupational therapy as an occupational therapy assistant or use the title "occupational therapy assistant." Practice as an occupational therapy assistant shall include the providing of occupational therapy and client related services under the direction and supervision of an occupational therapist or licensed physician in accordance with the commissioner’s regulations.”
34. New York State Education Department, Office of the Professions. Frequently Asked Questions for Occupational Therapists - Practice Issues. Checked October 30, 2026.
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    “Education Law requires that occupational therapy assistants work under the direction and supervision of a licensed occupational therapist or physician. Specific provisions regarding this supervision are found in Section 76.8 of the Commissioner’s Regulations. These regulations require the development of a written supervision plan by the supervisor, and generally provide that the level and type of supervision be set forth in that plan.”
35. New York State Senate (NYS Open Legislation). Education Law section 8209, Mandatory continuing competency. “Each licensed speech-language pathologist and audiologist required under this article to register triennially with the department to practice in the state shall comply with the provisions of the mandatory continuing competency requirements ...” Checked October 30, 2026.
36. New York State Senate (NYS Open Legislation). Education Law section 6502, Duration and registration of a license. Checked October 30, 2026.
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    “A license shall be valid during the life of the holder unless revoked, annulled or suspended by the board of regents ... A licensee must register with the department and meet the requirements prescribed in section 3-503 of the general obligations law to practice in this state.”
37. New York State Education Department, Office of the Professions. Continuing Education for Speech-Language Pathology. Checked October 30, 2026.
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    “Each licensed speech-language pathologist and audiologist in practice is required to complete 30 hours of continuing competency learning activities during every three-year registration cycle. Of these 30 hours, at least 20 must be completed in a "professional" area, and the remainder may be in a "related area." Please note, only two-thirds of the requirement can be met through self-directed online study from an approved provider, the other one-third must be in-person, live online, or synchronous online study from an approved provider or other learning activities as defined below.”
38. New York State Education Department, Office of the Professions. Speech-Language Pathologists & Audiologists: Frequently Asked Questions. Checked October 30, 2026.
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    “New York State law restricts the practice of speech-language pathology and audiology to licensed professionals. Individuals who are not licensed may not provide speech-language pathology or audiology services. People who are employed to assist speech-language pathologists or audiologists in such activities as cleaning equipment, preparing a room for therapy, or performing secretarial duties should not be referred to as "speech aides" or "audiology aides," as these terms may be misleading to the public.”
39. New York State Department of Health. Rehabilitation Services Manual Policy Guidelines (Version 2024-1). Checked October 30, 2026.
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    “Certified teachers of the speech and hearing handicapped (TSHH) or certified teachers of students with speech and language disabilities (TSSLD) employed by the federal, state or a local government or by a public or non-public elementary or secondary school or an institution of higher learning may provide speech therapy services “under the direction of” a qualified NYS licensed and currently registered speech-language pathologist in the course of such employment.”
40. New York State Senate (NYS Open Legislation). Education Law section 7901, Definition. Checked October 30, 2026.
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    “A treatment program designed to restore function, shall be rendered on the prescription or referral of a physician, nurse practitioner or other health care provider acting within his or her scope of practice pursuant to this title, except as provided for in subdivision two of this section. ... 2. Treatment may be rendered by a licensed occupational therapist for ten visits, or thirty days, whichever shall occur first, without a referral from a physician or nurse practitioner provided that: (a) the licensed occupational therapist has practiced occupational therapy on a full time basis equivalent to not less than three years; and (b) each occupational therapist licensed pursuant to this article shall provide written notice to each patient receiving treatment absent a referral from a physician or nurse practitioner that occupational therapy may not be covered by the patient’s health care plan or insurer without such a referral and that such treatment may be a covered expense if rendered pursuant to a referral.”
41. New York State Department of Health. Rehabilitation Services Manual Policy Guidelines (Version 2024-1). “Rehabilitation services must be ordered, in writing, by a physician, physician assistant, or nurse practitioner so authorized by law.” Checked October 30, 2026.
42. New York State Senate (NYS Open Legislation). Education Law section 8201, Definition of practice of speech-language pathology. Checked October 30, 2026.
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    “The practice of the profession of speech-language pathology shall mean the application of principles, methods and procedures of measurement, prediction, non-medical diagnosis, testing, counselling, consultation, rehabilitation and instruction related to the development and disorders of speech, voice, swallowing, and/or language for the purpose of preventing, ameliorating or modifying such disorder conditions in individuals and/or groups of individuals.”
43. New York State Education Department, Office of the Professions. Education Law section 8202. “Only a person licensed or otherwise authorized under this article shall practice speech-language pathology or use the title of speech-language pathologist.” Checked October 30, 2026.
44. New York State Department of Health. Rehabilitation Services Manual Policy Guidelines (Version 2024-1). “Rehabilitation services must be ordered, in writing, by a physician, physician assistant, or nurse practitioner so authorized by law. In addition, speech therapy services may be provided based on a written referral from a speech-language pathologist so authorized by law.” Checked October 30, 2026.
45. New York State Department of Health (eMedNY). Provider Enrollment. Checked October 30, 2026.
46. 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.”.
47. New York State Department of Health. Rehabilitation Services Procedure Codes & Fee Schedule (January 2026). “Services must be ordered, in writing, by a physician, physician assistant, or nurse practitioner so authorized by law. In addition, speech therapy services may be provided based on a written referral from a speech-language pathologist so authorized by law.” Checked October 30, 2026.
48. New York State Department of Health. Managed Care. “Medicaid Managed Care offers many New Yorkers a chance to choose a Medicaid health plan. Managed Care plans focus on preventive health care and provide enrollees with a medical home for themselves and their families.” Checked October 30, 2026.
49. New York State Department of Health. Managed Care. “Managed care plans pay the health care providers directly, so enrollees do not have to pay out-of-pocket for covered services or submit claim forms for care received from the plan’s network of doctors.” Checked October 30, 2026.
50. New York State Department of Health. Rehabilitation Services Procedure Codes & Fee Schedule (January 2026). Checked October 30, 2026.
51. New York State Department of Health. Rehabilitation Services Procedure Codes & Fee Schedule (January 2026). Checked October 30, 2026.
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    “GP Services delivered under an outpatient physical therapy plan of care. GO Services delivered under an outpatient occupational therapy plan of care. GN Services delivered under an outpatient speech-language pathology plan of care. ... The appropriate modifier must be used with therapy procedure codes on Medicaid claims.”
52. New York State Department of Health. eMedNY 150003 Billing Guidelines, Rehabilitation Services (Version 2011-01). “For physical/occupational therapy services, each 15 minutes equals 1 unit. For services in excess of 15 minutes (up to a maximum of 2 hours), indicate the number of 15-minute units provided.” Checked October 30, 2026.
53. New York State Department of Health. eMedNY 150003 Billing Guidelines, Rehabilitation Services (Version 2011-01). “For physical/occupational therapy services, each 15 minutes equals 1 unit. For services in excess of 15 minutes (up to a maximum of 2 hours), indicate the number of 15-minute units provided.” Checked October 30, 2026.
54. New York State Department of Health. eMedNY 150003 Billing Guidelines, Rehabilitation Services (Version 2011-01). “For speech pathology treatment, each ½ hour equals 1 unit. For sessions in excess of ½ hour, indicate the number of ½ hour units provided.” Checked October 30, 2026.
55. New York State Department of Health. Rehabilitation Services Procedure Codes & Fee Schedule (January 2026). “ST Services delivered to a patient with a traumatic brain injury (TBI) (as defined in Public Health Law Article 27-cc: § 2741 ...” Checked October 30, 2026.
56. New York State Department of Health. Rehabilitation Services Procedure Codes & Fee Schedule (January 2026). Checked October 30, 2026.
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    “The above fees apply to services rendered in a private office setting. If physical therapy, occupational therapy, or speech therapy services are rendered in any other setting (e.g., D&TC, HOPD, nursing home) the therapist cannot bill Medicaid directly and would be paid by the medical institution.”
57. New York State Department of Health. Rehabilitation Services Manual Policy Guidelines (Version 2024-1). Checked October 30, 2026.
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    “Physical Therapy (PT) assistants or Occupational Therapy (OT) assistants may provide services under the direction and supervision of their respective Physical or Occupational Therapist. ... Aides, athletic trainers, exercise physiologists, life skills trainers, special education teachers, paraprofessionals, and rehabilitation technicians do not meet the definition of a qualified practitioner regardless of the level of supervision.”
58. New York State Department of Health. Preschool/School Supportive Health Services Program (revised June 2010). Checked October 30, 2026.
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    “The purpose of SSHSP is to provide Medicaid reimbursement to school districts, §4201 schools and counties for certain diagnostic and health support services provided to Medicaid-eligible students with disabilities. The SSHSP applies to students from age three years up to their 21st birthday. Medicaid-reimbursable services under New York’s SSHSP, for children with disabilities who are eligible for Medicaid, include: Physical therapy services Occupational therapy services Speech therapy services ...”
59. New York State Department of Health. NYS Medicaid Telehealth Policy Manual (Updated July 2026). “A "telehealth provider," as defined in Public Health Law (PHL) §2999-cc, may be a physician, physician assistant, dentist, nurse practitioner, registered professional nurse, podiatrist, optometrist, ... speech language pathologist, physical therapist, occupational therapist ...” Checked October 30, 2026.
60. New York State Senate (NYS Open Legislation). Public Health Law section 2999-cc, Definitions. Checked October 30, 2026.
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    “"Telehealth provider" means: ... (j) a speech language pathologist or audiologist licensed pursuant to article one hundred fifty-nine of the education law; (k) a midwife licensed pursuant to article one hundred forty of the education law; (l) a physical therapist licensed pursuant to article one hundred thirty-six of the education law; (m) an occupational therapist licensed pursuant to article one hundred fifty-six of the education law ...”
61. New York State Department of Health. NYS Medicaid Telehealth Policy Manual (Updated July 2026). Checked October 30, 2026.
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    “Written consent by the NYS Medicaid member is not required, but the provider must document informed consent in the chart of the patient before or during the first visit in which ... telehealth services are provided. Telehealth sessions/services shall not be recorded without the consent of the NYS Medicaid member.”
62. New York State Senate (NYS Open Legislation). Insurance Law section 3217-h, Telehealth delivery of services. Checked October 30, 2026.
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    “(2) An insurer that provides comprehensive coverage for hospital, medical or surgical care shall reimburse covered services delivered by means of telehealth on the same basis, at the same rate, and to the same extent that such services are reimbursed when delivered in person; ... * NB Effective until April 1, 2028 ...”
63. New York State Senate (NYS Open Legislation). Insurance Law section 3217-h, Telehealth delivery of services. “An insurer shall not exclude from coverage a service that is otherwise covered under a policy that provides comprehensive coverage for hospital, medical or surgical care because the service is delivered via telehealth ...” Checked October 30, 2026.
64. New York State Department of Labor. Register for Unemployment Insurance. Checked October 30, 2026.
65. New York State Department of Labor. Register for Unemployment Insurance. Checked October 30, 2026.
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    “The law requires all employers to register for unemployment insurance when they meet the conditions for unemployment insurance liability. The conditions for liability differ for the following types of businesses. You must complete an employer registration form for us to decide if you are liable under the New York State Unemployment Insurance Law.”
66. New York State Department of Taxation and Finance. Publication 750, A Guide to Sales Tax in New York State (11/15). Checked October 30, 2026.
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    “Only certain services are subject to tax. These services include: • Providing certain information services. ... • Installing, maintaining, servicing, or repairing tangible personal property that is not held for sale by the purchaser of the service in the regular course of business ... • Storing tangible personal property that is not being held for sale ... • Protective or detective services.”
67. New York State Department of Taxation and Finance. Publication 822, Taxable Status of Medical Equipment and Supplies, Prosthetic Devices, and Related Items (6/01). Checked October 30, 2026.
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    “Sales of medical equipment, component parts, and medical supplies are exempt from New York State and local sales and use taxes unless sold for use in providing medical or similar services for compensation. Therefore, sales to physicians, dentists, hospitals, clinical laboratories, ambulance companies, and so forth are subject to tax. ... Prosthetic aids, hearing aids, eyeglasses, and artificial devices, and their component parts, are also exempt from tax.”
68. New York State Senate (NYS Open Legislation). Workers’ Compensation Law section 10, Liability for compensation. Checked October 30, 2026.
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    “1. Every employer subject to this chapter shall in accordance with this chapter, except as otherwise provided in section twenty-five-a hereof, secure compensation to his employees and pay or provide compensation for their disability or death from injury arising out of and in the course of the employment without regard to fault as a cause of the injury ...”
69. 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.”.
70. 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.”.
71. New York State Education Department, Office of the Professions. Rules of the Board of Regents, Part 29, section 29.1. “revealing of personally identifiable facts, data or information obtained in a professional capacity without the prior consent of the patient or client, except as authorized or required by law ...” Checked October 30, 2026.
72. New York State Senate (NYS Open Legislation). General Business Law section 899-aa. Checked October 30, 2026.
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    “2. Any person or business which owns or licenses computerized data which includes private information shall disclose any breach of the security of the system following discovery or notification of the breach in the security of the system to any resident of New York state whose private information was, or is reasonably believed to have been, accessed or acquired by a person without valid authorization. The disclosure shall be made in the most expedient time possible and without unreasonable delay, provided that such notification shall be made within thirty days after the breach has been discovered, except for the legitimate needs of law enforcement ...”
73. New York State Senate (NYS Open Legislation). Social Services Law section 413. Checked October 30, 2026.
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    “1. (a) The following persons and officials are required to report or cause a report to be made in accordance with this title when they have reasonable cause to suspect that a child coming before them in their professional or official capacity is an abused or maltreated child, ... any physician; registered physician assistant; surgeon; medical examiner; coroner; dentist; dental hygienist; osteopath; optometrist; chiropractor; podiatrist; resident; intern; athletic trainer; psychologist; registered nurse; social worker; emergency medical technician; licensed creative arts therapist; licensed marriage and family therapist; licensed mental health counselor; licensed psychoanalyst; licensed behavior analyst; certified behavior analyst assistant; hospital personnel engaged in the admission, examination, care or treatment of persons; a Christian Science practitioner; school official, which includes but is not limited to school teacher, school guidance counselor, school psychologist, school social worker, school nurse, school administrator or other school personnel required to hold a teaching or administrative license or certificate; full or part-time compensated school employee required to hold a temporary coaching license or professional coaching certificate; social services worker; employee of a publicly-funded emergency shelter for families with children; director of a children’s overnight camp, summer day camp or traveling summer day camp, as such camps are defined in section thirteen hundred ninety-two of the public health law; day care center worker; school-age child care worker; provider of family or group family day care; employee or volunteer in a residential care facility for children that is licensed, certified or operated by the office of children and family services; or any other child care or foster care worker; mental health professional; substance abuse counselor; alcoholism counselor; all persons credentialed by the office of alcoholism and substance abuse services; employees, who are expected to have regular and substantial contact with children, of a health home or health home care management agency contracting with a health home as designated by the department of health and authorized under section three hundred sixty-five-l of this chapter or such employees who provide home and community based services under a demonstration program pursuant to section eleven hundred fifteen of the federal social security act who are expected to have regular and substantial contact with children; peace officer; police officer; district attorney or assistant district attorney; investigator employed in the office of a district attorney; or other law enforcement official.”
74. New York State Senate (NYS Open Legislation). Insurance Law section 3216 (individual accident and health insurance policy provisions). Checked October 30, 2026.
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    “(B) Every policy that provides physician services, medical, major medical or similar comprehensive-type coverage shall provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in accordance with this paragraph ... provided however that such policy shall not contain any limitations on visits that are solely applied to the treatment of autism spectrum disorder. ... (viii) "therapeutic care" means services provided by licensed or certified speech therapists, occupational therapists, social workers, or physical therapists. ... (5) therapeutic care, including therapeutic care which is deemed habilitative or nonrestorative, in the event that the policy provides coverage for therapeutic care; ... (D) Coverage may be denied on the basis that such treatment is being provided to the covered person pursuant to an individualized education plan under article eighty-nine of the education law.”
75. 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.
76. New York State Workers’ Compensation Board. Medical Fee Schedules. Checked October 30, 2026.
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    “Health care providers participating in the NYS workers’ compensation system are paid for services according to set medical fee schedules. ... Payers must reimburse providers for services rendered in accordance with the Board’s medical fee schedules. ... Acupuncture and Physical & Occupational Therapy May purchase from RefMed or view in person at the locations listed in the Where to view section of this page.”
77. APTA New York. APTA New York (the state association's site). Checked October 30, 2026.
78. the New York State Occupational Therapy Association. the New York State Occupational Therapy Association (the state association's site). Checked October 30, 2026.
79. the New York State Speech-Language-Hearing Association. the New York State Speech-Language-Hearing Association (the state association's site). Checked October 30, 2026.
80. DrSensory. Occupational therapy clinics in New York, 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.
81. 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 New York, not legal, compliance, billing or financial advice. Rules change; the clinic confirms each with its source before acting on it.