North Dakota PT, OT and SLP guide

For OT, PT and SLP clinics in North Dakota: three state boards license the disciplines, the physical therapy board’s rules record that physical therapists were allowed to practice without a physician referral in 1989, North Dakota Medicaid covers children’s therapy under EPSDT and adults within its own rules, and telehealth follows the patient’s location.⁠^1,2,3,4,5,6

Who licenses OTs, PTs and SLPs in North Dakota?

Three state boards license the three disciplines in North Dakota, and each publishes its own licensing law, rules, renewal cycle and continuing-education requirement.⁠^1,7,8 A clinic that employs more than one discipline keeps three registers, not one.

Physical therapists and physical therapist assistants answer to the North Dakota Board of Physical Therapy.⁠^{1,45,46,47,48,49,50,51,52,53,54,55,56,57} Occupational therapists and occupational therapy assistants answer to the North Dakota State Board of Occupational Therapy Practice.⁠^{7,58,59,60,61,62,63,64,65,66,67,68,69,70,71} Speech-language pathologists answer to the North Dakota State Board of Examiners on Audiology and Speech-Language Pathology.⁠^{8,72,73,74,75,76,77,78,79,80,81,82,83,84} The North Dakota Board of Physical Therapy administers the physical therapy licensing law; it has three physical therapists, one physician, one physical therapist assistant and two public members, appointed by the governor.⁠^{1,45,46,47,48,49,50,51,52,53,54,55,56,57} No person or business may practice, advertise or bill physical therapy without a personal license or licensed employees, and employing an unlicensed physical therapist or physical therapist assistant to provide physical therapy is unlawful.⁠^{1,45,46,47,48,49,50,51,52,53,54,55,56,57} Occupational therapists and occupational therapy assistants are licensed by the Board of Occupational Therapy Practice, five governor-appointed members: three occupational therapists, one occupational therapy assistant and one consumer.⁠^{7,58,59,60,61,62,63,64,65,66,67,68,69,70,71} No one may practice occupational therapy or hold out as an occupational therapist in North Dakota without a license under the chapter, and only individuals are licensed.⁠^{7,58,59,60,61,62,63,64,65,66,67,68,69,70,71} Speech-language pathologists and speech-language pathology licensed assistants are licensed by the Board of Examiners on Audiology and Speech-Language Pathology, which also licenses audiologists; the act seats eight governor-appointed members.⁠^{8,72,73,74,75,76,77,78,79,80,81,82,83,84} No one may practice speech-language pathology, assist in its clinic, or represent as a speech-language pathologist or assistant in North Dakota without a license under the chapter.⁠^{8,72,73,74,75,76,77,78,79,80,81,82,83,84} 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 North Dakota 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.⁠^1,7,8 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 North Dakota PT, OT or SLP without a referral?

State law answers this discipline by discipline, and a payer may still require a referral the law does not. For physical therapy, the board’s rules record that in 1989 the legislature allowed physical therapists to practice without a physician referral; the licensing law defines physical therapy to include examining and evaluating to determine a diagnosis for physical therapy, prognosis and plan of intervention, and has a physical therapist inform and refer a patient whose findings fall outside the therapist’s knowledge, experience or expertise.⁠^{2,9,10,11,12,13} North Dakota Medicaid, as a payer, requires an order from a physician or other licensed practitioner for physical therapy evaluation and treatment, valid for one year. For workers’ compensation, Workforce Safety & Insurance has let a physical therapist serve as an injured employee’s primary treating provider since August 1, 2021.⁠^{2,9,10,11,12,13} For occupational therapy, the licensing act requires a license and defines occupational therapy to encompass evaluation, treatment, consultation, research and education.⁠^85,86,87 North Dakota Medicaid, as a payer, requires an order from a physician or other licensed practitioner for occupational therapy evaluation and treatment, valid for one year.⁠^85,86,87 For speech-language pathology, the licensing act requires a license and defines speech-language pathology to include measurement, testing, evaluation, identification, counseling and instruction related to the development and disorders of speech, language, voice, cognitive-communication, swallowing and augmentative alternative communication.⁠^88,89,90 North Dakota Medicaid, as a payer, requires an order from a physician or other licensed practitioner for speech-language pathology evaluation and treatment, valid for one year.⁠^88,89,90

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.⁠²⁶ North Dakota 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 North Dakota Medicaid pay for pediatric and adult therapy?

North Dakota Medicaid is run by the North Dakota Department of Health and Human Services, through its Medical Services Division, and a clinic enrolls through its provider enrollment route before it bills.⁠⁹¹ 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.⁠⁹² For members through age 20, North Dakota Medicaid’s EPSDT benefit covers screening for, and treatment of, discovered conditions. The therapy policies cover ongoing therapy that maximizes function for members who have experienced trauma, have a chronic condition, or have a congenital, deprivation or disease condition that interrupts or delays growth and development, and they state their yearly unit limits for members 21 and over.⁠^3,4,5,6

For members 21 and over, each therapy policy sets a calendar-year limit: 60 units of physical therapy, 60 units of occupational therapy and 30 units of speech therapy, with one evaluation a year in each. A 30-minute visit equals two 15-minute timed units or one untimed or 30-minute unit. Maintenance therapy is not covered, though services needed to sustain function or prevent deterioration may be.⁠^{14,15,16,17,18} North Dakota Medicaid requires a service authorization, obtained before the service, for additional evaluations, reevaluations, and units beyond the adult limits. The request uses the Service Limits Service Authorization Request (SFN 481) with the order and a copy of the current physician-signed plan of care. Retroactive authorization is considered only on good cause and when requested within 90 days of the service.⁠^{93,94,95,96,97,98} Medicaid Expansion, for adults 19 to 64 with household income up to 138 percent of the federal poverty level, is carried out through a private carrier except for pharmacy and for 19- and 20-year-olds, and Health and Human Services sends Expansion members to Blue Cross Blue Shield of North Dakota for questions on services.⁠^{99,100,101,102} The fee schedule is published by the agency, and a clinic reads the current file rather than a remembered rate.⁠¹⁰³

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

North Dakota Medicaid pays the lesser of the provider’s usual and customary charge or its fee schedule amount, set from relative value units and its conversion factor. Clinic therapy is billed on the CMS 1500 or 837P within 180 days of the service, a 15-minute unit counts once 8 minutes have passed, and from July 1, 2025 services by assistants carry the CQ (physical therapy), CO (occupational therapy) or UB (speech) modifier with the supervising provider listed as rendering.⁠^{104,105,106,107,108,109,110,111} 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 North Dakota Medicaid pay for therapy in schools?

Schools may bill North Dakota Medicaid for health-related services, physical, occupational and speech therapy among them, for students with and without IEPs. Only public school districts or special education units bill for IEP services, and therapy outside an IEP cannot duplicate the IEP’s therapy.⁠^{112,113,114,115} 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 North Dakota Medicaid cover therapy by telehealth?

North Dakota Medicaid’s telehealth policy names physical therapy, occupational therapy and speech-language pathology services among the examples that may be delivered by telehealth, checked code by code in its Procedure Code Look-up Tool. Telehealth must meet the in-person standard of care on a HIPAA-compliant platform.⁠^116,117,118 The telehealth section below covers the state’s own rules for the session itself.

What are North Dakota’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.⁠¹⁹ The physical therapy licensing law defines telehealth as electronic communications used to deliver health care services, including physical therapy, over any distance, and says telehealth does not meet its direct supervision requirement. The occupational therapy and speech boards’ rules count video teleconferencing or video conferencing as direct supervision of an assistant.⁠^{119,120,121,122}

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.⁠^20,21,22 An insurer’s health benefits policy covers health services delivered by telehealth the same as in person. The section counts individuals licensed under the physical therapy (43-26.1), speech (43-37) and occupational therapy (43-40) chapters as health care providers, and deductibles, coinsurance and copayments may apply.⁠^123,124,125

Which business steps are specific to North Dakota?

The entity is registered with the North Dakota Secretary of State, and the choice of entity is shaped by the state’s professional organizations act, which lets one professional organization render both physical therapy and occupational therapy.⁠^31,32,33,34 A professional corporation, limited liability company or limited liability partnership under the Professional Organizations Act is created to render one specific type of professional service, but one organization may render both physical therapy and occupational therapy, the services set out in NDCC chapters 43-26.1 and 43-40. The physical therapy act bars any business from practicing or billing physical therapy without personal licensure or licensed employees.⁠^35,36,37 State tax registration is with the North Dakota Office of State Tax Commissioner.⁠^126,127,128 North Dakota’s 5 percent sales tax applies to retail sales of tangible personal property, among the other items the statute lists. Sales of prosthetic devices, durable medical equipment, mobility-enhancing equipment and ostomy or bladder-dysfunction supplies are exempt, a prosthetic device being one sold under a doctor’s written prescription.⁠^129,130,131 Workforce Safety & Insurance (WSI) is the sole provider of workers’ compensation in North Dakota, and private insurers may not write it. The law, with limited exceptions, requires every employer to insure all employees, full-time, part-time, seasonal and occasional, before they begin working.⁠^132,133 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 North Dakota?

As a North Dakota Medicaid requirement, a provider keeps the documentation supporting its services for at least seven years, and the therapy policies say records are kept at least 7 years after the last date the claim was paid or denied. State law has a health care provider send a free copy of a patient’s records to another provider for continuing treatment, on the patient’s request.⁠^27,28,29,30 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.⁠^134,135

A person that owns or licenses computerized personal information, which includes medical and health insurance information, discloses a breach to each affected North Dakota resident in the most expedient time possible and without unreasonable delay, and tells the attorney general by mail or email of a breach affecting more than 250 individuals.⁠^{136,137,138,139} Medical and mental health professionals, among others, who know of or have reasonable cause to suspect child abuse or neglect from information received in their professional capacity report it to the department or its authorized agent. Physical and occupational therapists are named among the medical professionals who report abuse or neglect of a vulnerable adult.⁠^140,141,142

Which North Dakota rules shape a pediatric clinic?

North Dakota Early Intervention Services, the state’s Part C program in Health and Human Services, serves infants and toddlers from birth until their third birthday who have developmental delays. Assessments and evaluations are free to families, service plans can include home visits by occupational therapists, physical therapists and speech-language pathologists, and anyone can make a referral through the Developmental Disabilities regional office. Right Track, a free developmental screening and follow-along program, is open to all families with children birth through two.⁠^{38,39,40,41,42,43,44} 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.

Which North Dakota rules shape an adult clinic?

Medicare claims from North Dakota go to Noridian Healthcare Solutions, the Medicare Administrative Contractor for Jurisdiction F, Parts A and B (Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming), whose local coverage articles for therapy are the ones a North Dakota clinic reads.⁠¹⁴³ North Dakota Medicaid’s adult therapy rules are in the Medicaid section above. Workforce Safety & Insurance, as the sole workers’ compensation insurer, pays medical services from in-state and out-of-state providers by its own fee schedules, one of them for medical providers, and audits physical and occupational therapy against its documentation policy.⁠^{144,145,146,147}

Which associations and directory pages serve North Dakota?

The state chapters are APTA North Dakota for physical therapy, the North Dakota Occupational Therapy Association (NDOTA) for occupational therapy and the North Dakota Speech Language Hearing Association (NDSLHA) for speech-language pathology.⁠^148,149,150 On DrSensory, families browse North Dakota 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.⁠¹⁵¹

Which North Dakota cities have DrSensory city pages?

Beyond its three North Dakota pages, the directory publishes city pages for one North Dakota city, Fargo, three 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.⁠¹⁵¹

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

DrSensory lists 20 PT, OT and SLP clinics in North Dakota, on its occupational therapy, physical therapy and speech therapy pages for the state.⁠¹⁵¹

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

Which templates does a North Dakota launch need?

How might two North Dakota clinics plan a launch?

Sources

1. North Dakota Board of Physical Therapy. North Dakota Board of Physical Therapy. Checked October 30, 2026.
2. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 61.5-01-01-01, Organization of the North Dakota board of physical therapy. Checked October 30, 2026.
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   “In 1989, the legislative assembly allowed physical therapists to practice without a physician referral and in 2005 the fifty-ninth legislative assembly completely revised the physical therapy practice act and renamed the committee the North Dakota board of physical therapy.”
3. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Preventive Services and Chronic Disease Management and EPSDT Services. Checked October 30, 2026.
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   “North Dakota, EPSDT (Early and Periodic Screening, Diagnostic, and Treatment), previously known as Health Tracks, is a comprehensive wellness benefit that is integrated into regular wellness visits under Medicaid. EPSDT services focus on early and periodic screening for, and treatment of, discovered conditions for youth through age 20.”
4. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “Physical therapy provided on an ongoing basis to maximize the member’s functional level is covered for members who have ...” Checked October 30, 2026.
5. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “A condition due to congenital abnormality, deprivation, or disease that interrupts or delays the sequence and rate of normal growth, development, and maturation.” Checked October 30, 2026.
6. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “Physical therapy evaluations are limited to one per calendar year. Physical therapy units are limited to: • 60 units per calendar year for members age 21 and over.” Checked October 30, 2026.
7. North Dakota State Board of Occupational Therapy Practice. North Dakota State Board of Occupational Therapy Practice. Checked October 30, 2026.
8. North Dakota State Board of Examiners on Audiology and Speech-Language Pathology. North Dakota State Board of Examiners on Audiology and Speech-Language Pathology. Checked October 30, 2026.
9. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-01, Definitions (chapter 43-26.1, Physical Therapists). Checked October 30, 2026.
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   “Examining, evaluating, and testing individuals with mechanical, physiological, and developmental impairments, functional limitations in movement and mobility, and disabilities or other health and movement-related conditions to determine a diagnosis for physical therapy, prognosis, and plan of therapeutic intervention, and to assess the ongoing effects of intervention.”
10. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-11, Patient care management (chapter 43-26.1, Physical Therapists). “If the diagnostic process reveals findings outside the scope of a physical therapist’s knowledge, experience, or expertise, a physical therapist shall inform the patient or client and refer the patient or client to an appropriate practitioner.” Checked October 30, 2026.
11. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-14, Lawful practice (chapter 43-26.1, Physical Therapists). “A physical therapist or physical therapist assistant licensed under this chapter is fully authorized to practice physical therapy.” Checked October 30, 2026.
12. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “Physical therapy requires an order (prescription) for evaluation and treatment from a physician or other licensed practitioner (OLP) allowed to prescribe under their scope of practice according to state law. An order is valid for one (1) year.” Checked October 30, 2026.
13. North Dakota Workforce Safety & Insurance. Physical Therapist as Primary Treating Provider. “Since August 1, 2021, a physical therapist may serve as the primary treating provider for an injured employee. An injured employee may only have one primary treating provider, who is responsible for managing their care.” Checked October 30, 2026.
14. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “Physical therapy evaluations are limited to one per calendar year. Physical therapy units are limited to: • 60 units per calendar year for members age 21 and over.” Checked October 30, 2026.
15. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Occupational Therapy (updated April 2026). “Occupational therapy evaluations are limited to one per calendar year. Occupational therapy units are limited to: • 60 units per calendar year for members age 21 and over.” Checked October 30, 2026.
16. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Speech Language Pathology (updated April 2026). Checked October 30, 2026.
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    “Speech therapy evaluations are limited to one per calendar year. The speech therapy evaluation limit is a combined limit of CPT® codes 92521, 92522, and 92523. Speech therapy units are limited to: • 30 units per calendar year for members age 21 and over.”
17. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “For example, if a visit is 30 minutes, this equates to two (2) 15-minute timed units or one untimed or 30-minute unit.” Checked October 30, 2026.
18. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “ND Medicaid does not cover maintenance therapy. If therapy services are needed to sustain a level of function or if the member’s condition would otherwise deteriorate, services may be covered by ND Medicaid.” Checked October 30, 2026.
19. 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”.
20. PT Compact Commission. PT Compact Map (States by Category). “Member States (38) Alabama ... North Carolina North Dakota Ohio ...” Checked October 30, 2026.
21. PT Compact Commission. PT Compact Map. “38 Member States Actively Issuing and Accepting Compact Privileges ...” Checked October 30, 2026.
22. North Dakota Legislative Branch. North Dakota Century Code section 43-26.2-01, Physical therapy licensure compact (chapter 43-26.2, Physical Therapy Licensure Compact). “The purpose of this compact is to facilitate interstate practice of physical therapy with the goal of improving public access to physical therapy services.” Checked October 30, 2026.
23. 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. ... North Dakota Not Yet ND Jurisprudence Requirements ...” Checked October 30, 2026.
24. North Dakota Legislative Branch. North Dakota Century Code section 43-40.1-01, Purpose (chapter 43-40.1, Occupational Therapy Licensure Compact). “The purpose of this compact is to facilitate interstate practice of occupational therapy with the goal of improving public access to occupational therapy services.” Checked October 30, 2026.
25. North Dakota State Board of Occupational Therapy Practice. OT Licensure Compact (page updated February 17, 2026). “ND Century Code 43-40.1 - Occupational Therapy Licensure Compact Effective 8/1/2025. However, it is not yet issuing licenses or accepting applications. Applicants and licensees cannot apply for the compact now but will be able to in the future.” Checked October 30, 2026.
26. 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.”.
27. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 75-02-05-04, Provider responsibility (Medicaid provider integrity). Checked October 30, 2026.
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    “Each provider agrees to retain documentation to support medical services rendered for a minimum of seven years and, upon request, to make the documentation available to persons acting on behalf of the department and the United States department of health and human services.”
28. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “Records must be retained for at least 7 years after the last date the claim was paid or denied.” Checked October 30, 2026.
29. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Provider Requirements (updated October 2025). Checked October 30, 2026.
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    “Be kept for a minimum of seven (7) years from the date of their creation or the date when they were last in effect, whichever is later. Note: State law may require a longer retention period for some provider types.”
30. North Dakota Legislative Branch. North Dakota Century Code section 23-12-14, Copies of medical records and medical bills (chapter 23-12, Miscellaneous Health Regulations). Checked October 30, 2026.
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    “Upon the request of a health care provider’s patient or any person authorized by a patient, the provider shall provide a free copy of a patient’s health care records to a health care provider designated by the patient or ... the person authorized by the patient if the records are requested for the purpose of transferring that patient’s health care to another health care provider for the continuation of treatment.”
31. North Dakota Secretary of State. Business Services. “Most business registrations and maintenance are done through the FirstStop Portal.” Checked October 30, 2026.
32. North Dakota Secretary of State. Maintain Registration. “Most businesses in North Dakota must file an annual report with the Office of the Secretary of State to stay in good standing.” Checked October 30, 2026.
33. North Dakota Secretary of State. Maintain Registration. “Sole proprietorships and general partnerships do not need to file annual reports.” Checked October 30, 2026.
34. North Dakota Secretary of State. Corporation (Business Structures). “A corporation is created by filing articles of incorporation.” Checked October 30, 2026.
35. North Dakota Legislative Branch. North Dakota Century Code section 10-31-04, Purpose for which created - Minority ownership (chapter 10-31, Professional Organizations Act). Checked October 30, 2026.
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    “A professional organization may be created pursuant to this chapter only for the purpose of rendering one specific type of professional service and services ancillary thereto ... This subsection does not preclude an organization created pursuant to this chapter from rendering more than one specific type of professional service if the services rendered are set forth in chapters 43-03 and 43-19.1 or if the services rendered are set forth in chapters 43-26.1 and 43-40.”
36. North Dakota Legislative Branch. North Dakota Century Code section 10-31-01, Definitions (chapter 10-31, Professional Organizations Act). Checked October 30, 2026.
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    “"Professional service" means the personal service to the public which requires a license as a condition precedent to the rendering of such service and which requires as a condition of licensure an undergraduate or advanced college degree in the specific field.”
37. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-16, Representations and billings without licensure prohibited - Enforcement - Injunctions (chapter 43-26.1, Physical Therapists). Checked October 30, 2026.
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    “No person or business entities of any type shall practice physical therapy or hold themselves out, represent themselves, or send out billings as providing physical therapy services, without personal licensure or the use of licensed employees as provided in this chapter.”
38. North Dakota Health and Human Services. Early Intervention. “North Dakota Early Intervention Services can identify infants and young children (from birth until their third birthday) who have developmental delays when the right help can make all the difference. Developmental assessments and evaluations are provided at no cost to families.” Checked October 30, 2026.
39. North Dakota Health and Human Services. Early Intervention. “Home visitors may include (based on a child’s needs): Early Intervention Service Coordinator Early Childhood Special Education Teachers Occupational Therapists Physical Therapists Social Workers Speech Language Pathologists ...” Checked October 30, 2026.
40. North Dakota Health and Human Services. Early Intervention (Make a Referral to Early Intervention or Right Track Services). “To make a referral, please contact your Developmental Disabilities Regional Office listed below.” Checked October 30, 2026.
41. North Dakota Health and Human Services. Early Intervention. “Anyone can make a referral.” Checked October 30, 2026.
42. North Dakota Health and Human Services. Early Intervention. “A free developmental screening and follow-along program for you and your child, birth to three years of age.” Checked October 30, 2026.
43. North Dakota Health and Human Services. Early Intervention. “Right Track services are available to all families with children ages birth through two in North Dakota, not just for children with delays.” Checked October 30, 2026.
44. North Dakota Health and Human Services. Early Intervention: Federal Reporting. “Federal reporting to the Office of Special Education Programs. IDEA Part C Regulations North Dakota Part C Policy Package ...” Checked October 30, 2026.
45. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-02, Board of physical therapy - Members - Appointments - Vacancies (chapter 43-26.1, Physical Therapists). “The board of physical therapy shall administer this chapter. The board consists of three licensed physical therapists, one licensed physician, one licensed physical therapist assistant, and two public members.” Checked October 30, 2026.
46. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-02, Board of physical therapy - Members - Appointments - Vacancies (chapter 43-26.1, Physical Therapists). “The governor shall appoint board members for a term of five years, staggered so the terms of no more than two members expire each year.” Checked October 30, 2026.
47. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-16, Representations and billings without licensure prohibited - Enforcement - Injunctions (chapter 43-26.1, Physical Therapists). Checked October 30, 2026.
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    “No person or business entities of any type shall practice physical therapy or hold themselves out, represent themselves, or send out billings as providing physical therapy services, without personal licensure or the use of licensed employees as provided in this chapter. It shall be unlawful to employ an unlicensed physical therapist or physical therapist assistant to provide physical therapy services.”
48. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 61.5-02-02-05, Renewal of licensure (North Dakota Board of Physical Therapy). “Licenses not renewed annually by January thirty-first will expire.” Checked October 30, 2026.
49. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-08, License renewal - Changes (chapter 43-26.1, Physical Therapists). “A licensee shall renew the license annually pursuant to board rules.” Checked October 30, 2026.
50. North Dakota Board of Physical Therapy. License Renewal Application (page updated October 2, 2026). “Renewals are currently closed and will reopen on November 1.” Checked October 30, 2026.
51. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 61.5-03-01-02, Units, effective date, and requirements (continuing competence). “All physical therapists and physical therapist assistants must obtain twenty-five units of continuing competence every two years to be eligible for licensure or relicensure.” Checked October 30, 2026.
52. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 61.5-03-02-01, Unit standards (continuing competence). “One unit equals one hour of participation in competence activities.” Checked October 30, 2026.
53. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-11, Patient care management (chapter 43-26.1, Physical Therapists). “A physical therapist assistant shall work under the supervision of a physical therapist. A physical therapist assistant may document care provided without the cosignature of the supervising physical therapist.” Checked October 30, 2026.
54. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 61.5-05-01-02, Physical therapist assistants. “At least once after a sixth physical therapist assistant visit or at least once every thirty calendar days, whichever occurs first, a physical therapist must visit the patient.” Checked October 30, 2026.
55. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 61.5-05-01-02, Physical therapist assistants. “An initial visit must be made by the supervising physical therapist for evaluation of the patient and establishment of a plan of care.” Checked October 30, 2026.
56. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 61.5-05-01-05, Supervision ratios. “A physical therapist, at any one time, may supervise a maximum of three supportive personnel if no more than two are physical therapist assistants.” Checked October 30, 2026.
57. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-11, Patient care management (chapter 43-26.1, Physical Therapists). “A physical therapy aide shall work under the direct supervision of a physical therapist.” Checked October 30, 2026.
58. North Dakota Legislative Branch. North Dakota Century Code section 43-40-04, Board of occupational therapy practice - Appointment - Meetings (chapter 43-40, Occupational Therapists). “There is established a board of occupational therapy practice. The board shall consist of five members appointed by the governor, all of whom must be residents of this state.” Checked October 30, 2026.
59. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-01-01-01, Organization of the board of occupational therapy practice. Checked October 30, 2026.
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    “The board shall consist of five members appointed by the governor. Three members must be licensed occupational therapists, one member must be a licensed occupational therapy assistant, and one member must be a consumer.”
60. North Dakota Legislative Branch. North Dakota Century Code section 43-40-02, License required - Title - Abbreviation (chapter 43-40, Occupational Therapists). Checked October 30, 2026.
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    “A person may not practice occupational therapy or hold out as an occupational therapist, or as being able to practice occupational therapy, or to render occupational therapy services in this state unless that person is licensed under this chapter. Only individuals may be licensed under this chapter.”
61. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-01-02, Licensure renewal (occupational therapy). “Licenses are renewable biennially in even-numbered years.” Checked October 30, 2026.
62. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-01-02, Licensure renewal (occupational therapy). “Renewal applications, continued competency documentation, and fees must be postmarked or delivered to the board’s office on or before June first of the renewal year.” Checked October 30, 2026.
63. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-01-02, Licensure renewal (occupational therapy). “Occupational therapy licenses will expire if the renewal application, continued competency documentation, and fees are not postmarked or delivered to the board’s office by June thirtieth of the renewal year.” Checked October 30, 2026.
64. North Dakota State Board of Occupational Therapy Practice. Application for Renewal of License (page updated August 17, 2026). “OT and OTA licenses expired June 30, 2026, if you did not renew your license.” Checked October 30, 2026.
65. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-01-04, Continued competency (occupational therapy). “The board requires a minimum of twenty contact hours within the twenty-four months prior to the completed application for renewal of licensure. One contact hour is equal to one clock-hour.” Checked October 30, 2026.
66. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-01-04, Continued competency (occupational therapy). “Any licensee initially licensed between July first and December thirty-first of the odd-numbered year is required to complete ten contact hours for that licensing period with twenty contact hours for each subsequent licensing period.” Checked October 30, 2026.
67. North Dakota State Board of Occupational Therapy Practice. Continuing Education Requirements (page updated December 19, 2016). “All licensed Occupational Therapists and Occupational Therapy Assistants must acquire a minimum of twenty contact hours (2.0 CEU’s) within the twenty-four months prior to the date the completed application for renewal of licensure is received by the NDSBOTP office.” Checked October 30, 2026.
68. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-03-01.2, Supervision of occupational therapy assistants. “An occupational therapy assistant must be supervised by an occupational therapist. 1. An occupational therapist may not supervise more than three occupational therapy assistants licensed or limited permitholders at the same time.” Checked October 30, 2026.
69. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-03-01.2, Supervision of occupational therapy assistants. “An occupational therapist and a supervised occupational therapy assistant shall make a written supervision plan ...” Checked October 30, 2026.
70. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-03-01.2, Supervision of occupational therapy assistants. “An occupational therapist shall file with the board a substantiation of supervision form for each occupational therapy assistant supervised before the occupational therapy assistant may practice.” Checked October 30, 2026.
71. North Dakota Legislative Branch. North Dakota Century Code section 43-40-01, Definitions (chapter 43-40, Occupational Therapists). “"Occupational therapy assistant" means a person licensed to assist in the practice of occupational therapy, under this chapter, who works under the supervision of an occupational therapist.” Checked October 30, 2026.
72. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 11-01-01-01, Organization of board of examiners on audiology and speech-language pathology (amended effective July 1, 2026). “It is the responsibility of the board to license audiologists, speech-language pathologists, and speech-language pathology licensed assistants.” Checked October 30, 2026.
73. North Dakota Legislative Branch. North Dakota Century Code section 43-37-05, Board of examiners on audiology and speech-language pathology (chapter 43-37, Audiologists and Speech-Language Pathologists). “The board of examiners on audiology and speech-language pathology is hereby established. 2. The board is composed of eight members appointed by the governor.” Checked October 30, 2026.
74. North Dakota Legislative Branch. North Dakota Century Code section 43-37-03, License required - Exceptions (chapter 43-37, Audiologists and Speech-Language Pathologists). Checked October 30, 2026.
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    “A person may not practice audiology or speech-language pathology, assist in the practice of speech-language pathology, or represent the person is an audiologist, speech-language pathologist, or speech-language pathology assistant in this state unless licensed in accordance with this chapter.”
75. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 11-02-01-04, Renewal of licensure and relicensure. “A license must be renewed by the board if, on or before the thirty-first day of January of each year, the licensee meets all of the following requirements ...” Checked October 30, 2026.
76. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 11-02-01-04, Renewal of licensure and relicensure. “Applications for the renewal of license are due by the first date of each year.” Checked October 30, 2026.
77. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 11-02-01-04, Renewal of licensure and relicensure. Checked October 30, 2026.
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    “If the completed application for renewal, renewal fee, and proof of completion of continuing education are not filed before the first day of each year, the license must expire, the individual may not practice, and the renewal application must be completed by January thirty-first.”
78. North Dakota State Board of Examiners on Audiology and Speech-Language Pathology. License Renewal (page updated October 1, 2024). “The North Dakota State Board of Examiners on Audiology and Speech-Language Pathology License expires each year on December 31st.” Checked October 30, 2026.
79. North Dakota State Board of Examiners on Audiology and Speech-Language Pathology. Frequently Asked Questions (page updated May 11, 2026). “The renewal form and fee along with the proof of continuing education should be submitted and postmarked no later than December 1st of each year.” Checked October 30, 2026.
80. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 11-02-01-06, Continuing education (amended effective July 1, 2026). “Licensees are required to complete ten clock hours of continuing education during each calendar year.” Checked October 30, 2026.
81. North Dakota State Board of Examiners on Audiology and Speech-Language Pathology. Frequently Asked Questions (page updated May 11, 2026). “To maintain a current license in the state of North Dakota, Audiologists, Speech-Language Pathologists (SLPs) and a Speech-Language Pathology Licensed Assistant (SLP-LA) must have one (1) Continuing Education Unit which equals to ten (10) hours.” Checked October 30, 2026.
82. North Dakota Legislative Branch. North Dakota Century Code section 43-37-04.2, Speech-language pathology assistant - Supervising speech-language pathologist (chapter 43-37, Audiologists and Speech-Language Pathologists). Checked October 30, 2026.
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    “A speech-language pathology assistant is licensed by the board to work under the supervision of a speech-language pathologist. A speech-language pathology assistant’s scope of practice is limited to tasks the supervising speech-language pathologist delegates.”
83. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 11-02-01-08, Speech-language pathology licensed assistants. “A speech-language pathology licensed assistant must be supervised by a licensed speech-language pathologist who has been actively practicing for eighteen months post initial licensure.” Checked October 30, 2026.
84. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 11-02-01-08, Speech-language pathology licensed assistants. “A speech-language pathologist may be the supervisor of record for no more than three speech-language pathology licensed assistants at the same time.” Checked October 30, 2026.
85. North Dakota Legislative Branch. North Dakota Century Code section 43-40-01, Definitions (chapter 43-40, Occupational Therapists). “Occupational therapy encompasses evaluation, treatment, consultation, research, and education. Occupational therapy practice includes evaluation by skilled observation, administration, and interpretation of standardized and nonstandardized tests and measurements.” Checked October 30, 2026.
86. North Dakota Legislative Branch. North Dakota Century Code section 43-40-02, License required - Title - Abbreviation (chapter 43-40, Occupational Therapists). Checked October 30, 2026.
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    “A person may not practice occupational therapy or hold out as an occupational therapist, or as being able to practice occupational therapy, or to render occupational therapy services in this state unless that person is licensed under this chapter.”
87. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Occupational Therapy (updated April 2026). Checked October 30, 2026.
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    “Occupational therapy requires an order (prescription) for evaluation and treatment from a physician or other licensed practitioner (OLP) allowed to prescribe occupational therapy under their scope of practice according to state law. An order is valid for one (1) year.”
88. North Dakota Legislative Branch. North Dakota Century Code section 43-37-02, Definitions (chapter 43-37, Audiologists and Speech-Language Pathologists). “"Speech-language pathology" means the application of principles, methods, and procedures for measurement, testing, evaluation, identification, prediction, counseling, or instruction related to the development and disorders of speech, language, voice, cognitive-communication, swallowing, and augmentative alternative communication ...” Checked October 30, 2026.
89. North Dakota Legislative Branch. North Dakota Century Code section 43-37-03, License required - Exceptions (chapter 43-37, Audiologists and Speech-Language Pathologists). Checked October 30, 2026.
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    “A person may not practice audiology or speech-language pathology, assist in the practice of speech-language pathology, or represent the person is an audiologist, speech-language pathologist, or speech-language pathology assistant in this state unless licensed in accordance with this chapter.”
90. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Speech Language Pathology (updated April 2026). Checked October 30, 2026.
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    “Speech-language pathology services require an order (prescription) for evaluation and treatment from a physician or other licensed practitioner (OLP) allowed to prescribe under their scope of practice according to state law. An order is valid for one (1) year.”
91. North Dakota Health and Human Services. Medicaid Provider Enrollment. Checked October 30, 2026.
92. 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.”.
93. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “If additional units over the limits are medically necessary for a member, the provider must submit a service authorization prior to performing additional services.” Checked October 30, 2026.
94. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “ND Medicaid requires a service authorization for: • Additional evaluations, • Reevaluations, and • Therapy units that exceed the following limits ...” Checked October 30, 2026.
95. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “The physical therapist must obtain an approved service authorization from ND Medicaid for the member prior to performing the requested services.” Checked October 30, 2026.
96. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “A completed and current version of the Service Limits Service Authorization Request (SFN 481) with the corresponding order for services; • A copy of the current physician signed plan of care ...” Checked October 30, 2026.
97. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). Checked October 30, 2026.
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    “To be eligible for retroactive authorization consideration, all requirements for service authorization must be met, and ND Medicaid must receive the retroactive authorization request no later than 90 days from the date the service. The physical therapy provider must demonstrate good cause for the failure to secure the required service authorization prior to performing the services.”
98. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “With each 90-day interval, the plan of care must be certified (signed and dated) by the ordering or referring provider who has knowledge of the need for and supports ongoing therapy services for the member.” Checked October 30, 2026.
99. North Dakota Legislative Branch. North Dakota Century Code section 50-24.1-37, Medicaid expansion - Legislative management report (chapter 50-24.1, Medical Assistance for Needy Persons). “Except for pharmacy services and coverages for individuals ages nineteen and twenty, the department shall implement the expansion by bidding through private carriers or utilizing the health insurance exchange.” Checked October 30, 2026.
100. North Dakota Health and Human Services. Medicaid Expansion. “Medicaid Expansion is available to individuals between 19-64 with household incomes up to 138% of the federal poverty level (FPL).” Checked October 30, 2026.
101. North Dakota Health and Human Services. Medicaid Expansion. “For questions on services and other support, contact Blue Cross Blue Shield of North Dakota Member Services.” Checked October 30, 2026.
102. North Dakota Legislative Branch. North Dakota Century Code section 50-24.1-28.1, Pharmacy management program (chapter 50-24.1, Medical Assistance for Needy Persons). “... provide the contracted managed care plan with a daily pharmacy claims file for Medicaid expansion recipients.” Checked October 30, 2026.
103. North Dakota Health and Human Services. Rates and Fee Schedules. Checked October 30, 2026.
104. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). Checked October 30, 2026.
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     “Payment for services is limited to the lesser of the provider’s usual and customary charge or the ND Medicaid calculated reimbursement. Physical therapy services are reimbursed according to the ND Medicaid fee schedule. Fees are calculated based on the relative value unit (RVU) and the ND Medicaid conversion factor.”
105. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “Physical therapy services must be billed using the CMS 1500 claim form or 837P.” Checked October 30, 2026.
106. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “ND Medicaid must receive an original Medicaid primary claim within one hundred eighty (180) days from the date of service.” Checked October 30, 2026.
107. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “A unit of time is attained when the mid-point is passed. For example, a 15-minute unit is attained when 8 minutes have elapsed.” Checked October 30, 2026.
108. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “Effective for dates of service July 1, 2025, forward, ND Medicaid will require services rendered by a certified physical therapy assistant (PTA) to be identified on the claim line using the CQ modifier.” Checked October 30, 2026.
109. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Occupational Therapy (updated April 2026). “Effective for dates of service July 1, 2025, and forward, ND Medicaid will require services rendered by a certified occupational therapy assistant (OTA) to be identified on the claim line using the CO modifier.” Checked October 30, 2026.
110. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Speech Language Pathology (updated April 2026). “Effective for dates of service July 1, 2025, and forward, ND Medicaid will require services rendered by a certified speech language pathology therapy assistant (SLPA) to be identified on the claim line using the UB modifier.” Checked October 30, 2026.
111. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “The supervising provider NPI and taxonomy must be listed as the rendering (CMS 1500 claim form or 837p) or attending (UB 04 claim form or 837i) provider on the claim.” Checked October 30, 2026.
112. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: School-Based Services (updated July 2026). “Schools may bill ND Medicaid for health-related services provided to students with Individualized Education Plans (IEPs) and students without IEPs.” Checked October 30, 2026.
113. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: School-Based Services (updated July 2026). “School-based services can be provided by the following enrolled providers as allowed by their scope of their licensure: • Physical therapists; • Occupational therapists; • Speech language therapists ...” Checked October 30, 2026.
114. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: School-Based Services (updated July 2026). “Only public-school districts or special education units may bill for IEP services.” Checked October 30, 2026.
115. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Physical Therapy (updated April 2026). “Therapy services received outside of an IEP cannot duplicate therapy services received through the member’s IEP.” Checked October 30, 2026.
116. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Telehealth (updated October 2025). “All qualified telehealth services must: • Meet the same standard of care as in-person care ...” Checked October 30, 2026.
117. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Telehealth (updated October 2025). Checked October 30, 2026.
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     “The Procedure Code Look-up Tool should be utilized to verify if specific codes can be delivered via telehealth. Examples include, but are not limited to, the following: ... • Occupational Therapy Services; • Physical Therapy Services; • Speech Language Pathology Services ...”
118. North Dakota Health and Human Services. North Dakota Medicaid Billing and Policy Manual: Telehealth (updated October 2025). “The service must be provided using a ... HIPAA-compliant platform; ...” Checked October 30, 2026.
119. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-01, Definitions (chapter 43-26.1, Physical Therapists). “"Telehealth" is the use of electronic communications to provide and deliver health-related information and health care services, including physical therapy related information and services, over any distance.” Checked October 30, 2026.
120. North Dakota Legislative Branch. North Dakota Century Code section 43-26.1-01, Definitions (chapter 43-26.1, Physical Therapists). “Telehealth does not meet the requirement for direct supervision.” Checked October 30, 2026.
121. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 55.5-02-03-01.1, Definitions (occupational therapy supervision). “"Direct supervision" means face-to-face contact, including observation, modeling, cotreatment, discussions, teaching, and video teleconferencing.” Checked October 30, 2026.
122. North Dakota Legislative Branch (North Dakota Administrative Code). North Dakota Administrative Code section 11-02-01-08, Speech-language pathology licensed assistants. “"Direct supervision" means face-to-face contact that occurs in-person or through video conferencing.” Checked October 30, 2026.
123. North Dakota Legislative Branch. North Dakota Century Code section 26.1-36-09.15, Coverage of telehealth services (chapter 26.1-36, Accident and Health Insurance). Checked October 30, 2026.
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     “An insurer may not deliver, issue, execute, or renew a policy that provides health benefits coverage unless that policy provides coverage for health services delivered by means of telehealth which is the same as the coverage for health services delivered by in-person means.”
124. North Dakota Legislative Branch. North Dakota Century Code section 26.1-36-09.15, Coverage of telehealth services (chapter 26.1-36, Accident and Health Insurance). Checked October 30, 2026.
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     “"Health care provider" includes an individual licensed under chapter 43-05, 43-06, 43-12.1 as a registered nurse or as an advanced practice registered nurse, 43-13, 43-15, 43-17, 43-26.1, 43-28, 43-32, 43-37, 43-40, 43-41, 43-42, 43-44, 43-45, 43-47, 43-58, or 43-60.”
125. North Dakota Legislative Branch. North Dakota Century Code section 26.1-36-09.15, Coverage of telehealth services (chapter 26.1-36, Accident and Health Insurance). “Coverage under this section may be subject to deductible, coinsurance, and copayment provisions.” Checked October 30, 2026.
126. North Dakota Office of State Tax Commissioner. Income Tax Withholding. “Businesses may have to submit North Dakota income tax withholding if they are: An employer paying wages to an employee if the employee performs services in North Dakota and the wages are subject to federal income tax withholding.” Checked October 30, 2026.
127. North Dakota Office of State Tax Commissioner. Sales and Use Tax. “Apply for a Sales and Use Tax Permit ...” Checked October 30, 2026.
128. North Dakota Office of State Tax Commissioner. Sales and Use Tax. “North Dakota imposes a sales tax on retail sales. The sales tax is paid by the purchaser and collected by the seller.” Checked October 30, 2026.
129. North Dakota Legislative Branch. North Dakota Century Code section 57-39.2-02.1, Sales tax imposed (chapter 57-39.2, Sales Tax). Checked October 30, 2026.
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     “Except as otherwise expressly provided in this chapter, there is imposed a tax of five percent upon the gross receipts of retailers from all sales at retail, including the leasing or renting of tangible personal property as provided in this section, within this state of the following to consumers or users: a. Tangible personal property, consisting of goods, wares, or merchandise, and bundled transactions consisting entirely of tangible personal property.”
130. North Dakota Legislative Branch. North Dakota Century Code section 57-39.2-04, Exemptions (subsection 26) (chapter 57-39.2, Sales Tax). “Gross receipts from sales of prosthetic devices, durable medical equipment, mobility-enhancing equipment, or supplies for ostomy care or bladder dysfunction.” Checked October 30, 2026.
131. North Dakota Legislative Branch. North Dakota Century Code section 57-39.2-04, Exemptions (subsection 26) (chapter 57-39.2, Sales Tax). “"Prosthetic device" means a replacement, corrective, or supportive device sold under a doctor’s written prescription ...” Checked October 30, 2026.
132. North Dakota Workforce Safety & Insurance. Coverage Requirements. “WSI is the sole provider and administrator of workers’ compensation in North Dakota. WSI is an exclusive employer-financed, no-fault insurance system covering workplace injuries, illnesses, and death. North Dakota law does not allow private insurers to underwrite workers’ compensation insurance in North Dakota.” Checked October 30, 2026.
133. North Dakota Workforce Safety & Insurance. Coverage Requirements. “North Dakota’s Workers’ Compensation law, with limited exceptions, requires all employers to insure all employees including full-time, part-time, seasonal, and occasional workers before employees begin working.” Checked October 30, 2026.
134. 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.”.
135. 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.”.
136. North Dakota Legislative Branch. North Dakota Century Code section 51-30-02, Notice to attorney general and consumers (chapter 51-30, Notice of Security Breach for Personal Information). Checked October 30, 2026.
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     “Any person that owns or licenses computerized data that includes personal information, shall disclose any breach of the security system following discovery or notification of the breach in the security of the data to any resident of the state whose unencrypted personal information was, or is reasonably believed to have been, acquired by an unauthorized person.”
137. North Dakota Legislative Branch. North Dakota Century Code section 51-30-02, Notice to attorney general and consumers (chapter 51-30, Notice of Security Breach for Personal Information). Checked October 30, 2026.
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     “... any person that experiences a breach of the security system as provided in this section shall disclose to the attorney general by mail or electronic mail any breach of the security system which exceeds two hundred fifty individuals. The disclosure must be made in the most expedient time possible and without unreasonable delay ...”
138. North Dakota Legislative Branch. North Dakota Century Code section 51-30-01, Definitions (chapter 51-30, Notice of Security Breach for Personal Information). Checked October 30, 2026.
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     “"Personal information" means an individual’s first name or first initial and last name in combination with any of the following data elements, when the name and the data elements are not encrypted: ... Medical information; ... Health insurance information ...”
139. North Dakota Legislative Branch. North Dakota Century Code section 51-30-01, Definitions (chapter 51-30, Notice of Security Breach for Personal Information). “"Medical information" means any information regarding an individual’s medical history, mental or physical condition, or medical treatment or diagnosis by a health care professional.” Checked October 30, 2026.
140. North Dakota Legislative Branch. North Dakota Century Code section 50-25.1-03, Persons required and permitted to report - To whom reported (chapter 50-25.1, Child Abuse and Neglect). Checked October 30, 2026.
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     “... or any other medical or mental health professional, religious practitioner of the healing arts, schoolteacher or administrator, school counselor, child care worker, foster parent, police or law enforcement officer, juvenile court personnel, probation officer, division of juvenile services employee, licensed social worker, family service specialist, child care licensor, or member of the clergy having knowledge of or reasonable cause to suspect a child is abused or neglected, or has died as a result of abuse or neglect, shall report the circumstances to the department or authorized agent if the knowledge or suspicion is derived from information received by that individual in that individual’s official or professional capacity.”
141. North Dakota Legislative Branch. North Dakota Century Code section 50-25.2-03, Reporting of abuse or neglect - Method of reporting (chapter 50-25.2, Vulnerable Adult Protective Services). Checked October 30, 2026.
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     “"medical or mental health professional or personnel" means a professional or personnel providing health care or services to a vulnerable adult, on a full-time or part-time basis, on an individual basis or at the request of a caregiver, and includes a medical examiner, coroner, dentist, dental hygienist, optometrist, pharmacist, chiropractor, podiatrist, physical therapist, occupational therapist ...”
142. North Dakota Legislative Branch. North Dakota Century Code section 50-25.2-03, Reporting of abuse or neglect - Method of reporting (chapter 50-25.2, Vulnerable Adult Protective Services). Checked October 30, 2026.
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     “Any medical or mental health professional or personnel, law enforcement officer, firefighter, member of the clergy, or caregiver having knowledge a vulnerable adult has been subjected to abuse or neglect ...”
143. Centers for Medicare & Medicaid Services. Who are the MACs: A/B MAC Jurisdiction F (JF). “Contract Awardee: Noridian Healthcare Solutions, LLC ... JF processes FFS Medicare Part A and Part B claims for Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming ...” Checked October 30, 2026.
144. North Dakota Workforce Safety & Insurance. Billing & Payment (Medical Fee Schedules). “WSI reimburses for a medical service in accordance with the WSI Fee Schedule for both an in-state and out-of-state provider.” Checked October 30, 2026.
145. North Dakota Workforce Safety & Insurance. Billing & Payment (Medical Fee Schedules). “WSI has established Fee Schedules for the following services: ... Medical Provider ...” Checked October 30, 2026.
146. North Dakota Workforce Safety & Insurance. Billing & Payment. “As the sole insurer of workers’ compensation in North Dakota, WSI manages all elements of billing and payment for a medical service provided to an injured employee covered by WSI.” Checked October 30, 2026.
147. North Dakota Workforce Safety & Insurance. Physical and Occupational Therapy Documentation (reviewed June 19, 2025). “WSI will audit all therapy services based on the criteria outlined in this policy and reduce or deny reimbursement of any billed service authentic medical documentation does not support.” Checked October 30, 2026.
148. APTA North Dakota. APTA North Dakota (the state association's site). Checked October 30, 2026.
149. the North Dakota Occupational Therapy Association (NDOTA). the North Dakota Occupational Therapy Association (NDOTA) (the state association's site). Checked October 30, 2026.
150. the North Dakota Speech Language Hearing Association (NDSLHA). the North Dakota Speech Language Hearing Association (NDSLHA) (the state association's site). Checked October 30, 2026.
151. DrSensory. Occupational therapy clinics in North Dakota, 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.
152. 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 North Dakota, not legal, compliance, billing or financial advice. Rules change; the clinic confirms each with its source before acting on it.