Pennsylvania therapy practice guide: PT, OT and SLP

For OT, PT and SLP clinics in Pennsylvania: three state boards license the disciplines; a patient may start physical therapy without a referral for up to 30 days, with a therapist who holds the board’s direct access certificate; Medical Assistance 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 Pennsylvania?

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

Physical therapists and physical therapist assistants answer to the Pennsylvania State Board of Physical Therapy.⁠^{1,23,24,25,26,27} Occupational therapists and occupational therapy assistants answer to the Pennsylvania State Board of Occupational Therapy Education and Licensure.⁠^{5,28,29,30,31} Speech-language pathologists answer to the Pennsylvania State Board of Examiners in Speech-Language Pathology and Audiology.⁠^{6,32,33,34,35} 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 Pennsylvania license renewal require?

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

Can a patient see a Pennsylvania 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 who holds the board’s certificate of authorization to practice without a referral may treat a patient without one for up to 30 days from the first treatment, after which a referral is required from a physician, a physician assistant or certified registered nurse practitioner under their agreements, or a dentist or podiatrist within their scope; the act lets an insurer or other payer still require a referral.⁠^2,7 For occupational therapy, an occupational therapist may evaluate a patient, consult and provide indirect services and other occupational therapy services for conditions such as perceptual, cognitive and sensory integration conditions without a referral, but direct occupational therapy for a specific medical condition must be based on a referral from a licensed physician, optometrist, podiatrist, certified registered nurse practitioner or physician assistant.⁠^36,37 For speech-language pathology, the licensure act defines a speech-language pathologist as an independent practitioner in hospitals, clinics, schools, private clinics and other settings and conditions no evaluation or treatment on a physician’s referral; it requires the pathologist to refer a patient with a suspected medical condition beyond the scope of practice to a physician for medical evaluation within 30 days.⁠³⁸

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.⁠¹⁴ Medical Assistance’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 Medical Assistance pay for pediatric and adult therapy?

Medical Assistance is Pennsylvania’s Medicaid program, run by the Department of Human Services, and a clinic enrolls through its provider enrollment route before it bills.⁠³⁹ For children, the federal EPSDT benefit requires the state to cover services that correct or ameliorate a condition found at a screening, whether or not the state plan covers them for adults.⁠⁴⁰ Medical Assistance’s benefit chart covers services by enrolled physical, occupational and speech/hearing therapists in the children’s package when medically necessary, and states that beneficiaries under 21 are eligible for all medically necessary Medical Assistance services. Children under 18 with disabilities whose parents earn too much for other categories may qualify through the PH95 category, which includes rehabilitation services.⁠^3,4

For beneficiaries 21 and older in the adult benefit package, Medical Assistance’s benefit chart covers physical, occupational and speech/hearing therapist services only when a hospital, outpatient clinic or home health provider provides them.⁠⁸ Medical Assistance requires prior authorization for the services and items its fee schedule marks with the prior authorization indicator, and since July 18, 2025 the department screens fee-for-service prior authorization requests against MCG care guidelines, including home care visits for physical therapy, occupational therapy and speech pathology.⁠^41,42 Physical HealthChoices is Pennsylvania’s mandatory managed care program for Medical Assistance recipients, delivered through physical health managed care organizations that the department lists by region. In the Southeast region, which includes Philadelphia, the plans listed are Geisinger Health Plan, Jefferson Health Plans EverWell, Keystone First, UnitedHealthcare Community Plan and UPMC for You.⁠^43,44 The fee schedule is published by the agency, and a clinic reads the current file rather than a remembered rate.⁠⁴⁵

How does Medical Assistance want OT, PT and SLP claims coded?

Physical, occupational and speech/hearing therapists enroll in Medical Assistance as provider type 17, Therapist, under specialty codes 170, 171 and 173, with separate specialties 176, 177 and 178 for early intervention services to children from birth to age 3. For fee-for-service telehealth, claims carry place of service 02, or 10 when the service reaches the beneficiary at home.⁠^46,47,48 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 Medical Assistance pay for therapy in schools?

Through the School-Based ACCESS Program, local education agencies enrolled in Medical Assistance are reimbursed for direct health-related services to Medical Assistance-eligible students aged 3 through 20 when the services are documented in an IEP or IFSP.⁠⁴⁹ 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 Medical Assistance cover therapy by telehealth?

Medical Assistance Bulletin 99-23-08 (August 2, 2023) pays fee-for-service services rendered by telehealth at the same rate as in person, requires two-way, real-time interactive technology, allows audio-only when the beneficiary lacks video or the situation is urgent, and identifies telehealth by place of service 02, or 10 when delivered in the beneficiary’s home.⁠⁵⁰ The telehealth section below covers the state’s own rules for the session itself.

What are Pennsylvania’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 Pennsylvania’s telemedicine law, 40 Pa.C.S. Chapter 48 (Act 42 of 2024), holds a health care provider who treats through telemedicine to the same standard of care that applies in person. For Medical Assistance, the department requires the provider to obtain the beneficiary’s or guardian’s consent before a telehealth service and to let the beneficiary return to in-person care at any time.⁠^51,52

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.⁠^10,11 40 Pa.C.S. section 4803 requires a health insurance policy issued in Pennsylvania to cover medically necessary services delivered through telemedicine by a participating network provider and bars excluding a service solely because it is delivered that way, with payment set by the contract negotiated between the insurer and the provider. Section 4804 requires Medical Assistance and CHIP managed care plans to pay for medically necessary telemedicine services that would be covered in person, beginning on or after January 1, 2026.⁠⁵³

Which business steps are specific to Pennsylvania?

The entity is registered with the Pennsylvania Department of State, and the choice of entity is shaped by the state’s rule on who may own a therapy business.⁠¹⁸ Pennsylvania lets licensed persons practice through a professional corporation, formed for one kind of professional service unless the boards regulating each profession allow combined practice, and, unless a profession’s own statute or rule provides otherwise, every ultimate beneficial owner of its shares must be a licensed person. The speech-language pathology board also lets a business entity provide licensed services once it files a certification with the board.⁠^19,20 State tax registration is with the Department of Revenue, for employer withholding.⁠⁵⁴ Pennsylvania’s sales and use tax reaches the sale of tangible goods and only certain listed services, and a business that sells taxable items or performs taxable services needs a Sales, Use and Hotel Occupancy Retail Tax License. The tax does not apply to medical supplies, crutches, wheelchairs, braces and supports for people with disabilities, or other therapeutic or prosthetic devices designed for a particular person’s physical incapacity.⁠^55,56 Every Pennsylvania employer liable under the Workers’ Compensation Act must insure its compensation liability through the State Workers’ Insurance Fund or an insurer authorized in Pennsylvania, unless the Department of Labor and Industry exempts it to self-insure.⁠⁵⁷ 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 Pennsylvania?

Pennsylvania’s speech-language pathology board requires a licensee to keep each person’s record at least 7 years from the date of the last entry. The physical therapy board’s rule requires adequate patient records, and Medical Assistance requires providers to keep records of services to its recipients at least 4 years unless the provider regulations say otherwise.⁠^15,16,17 Two federal periods sit beside it and are often confused with it: Medicare requires 7 years for documentation of orders, certifications, referrals and payment requests, and HIPAA requires 6 years for its own compliance documentation, and neither sets the retention period for the clinical chart.⁠^58,59

Pennsylvania’s Breach of Personal Information Notification Act requires an entity that maintains computerized personal information to notify affected Pennsylvania residents of a breach without unreasonable delay, and to notify the Attorney General at the same time when more than 500 residents must be notified. A HIPAA covered entity or business associate that complies with the HIPAA and HITECH privacy and security standards is deemed to comply with the act.⁠^60,61 Pennsylvania’s Child Protective Services Law makes every person licensed or certified in a health-related field under the Department of State, whose licensing boards include the physical therapy, occupational therapy and speech-language pathology boards, a mandated reporter of suspected child abuse. Each of the three boards also requires 2 hours of child abuse recognition and reporting training for renewal.⁠^{62,63,64,65,66}

Which Pennsylvania rules shape a pediatric clinic?

Pennsylvania’s Early Intervention program serves children from birth to age five with developmental delays and disabilities at no cost to families. Anyone with a concern about a child’s development contacts Pennsylvania Statewide CONNECT, which refers the family to a local program for screening and, if appropriate, an evaluation. Medical Assistance publishes a separate Early Intervention fee schedule for infant and toddler services.⁠^21,22 A private clinic’s services run beside the early intervention program rather than inside it. Section 635.2 of the Insurance Company Law requires covered health insurance policies and government programs to cover the diagnostic assessment and treatment of autism spectrum disorders for people under 21, with treatment including therapeutic care by speech-language pathologists, occupational therapists and physical therapists. Insurer coverage carries a yearly maximum benefit that the statute sets and the Insurance Commissioner adjusts each year, with no limit on visits, and the section reaches policies for groups of 51 or more employees.⁠⁶⁷ The autism insurance mandates guide covers how such a mandate meets a plan’s own terms.

Which Pennsylvania rules shape an adult clinic?

Medicare claims from Pennsylvania go to Novitas Solutions, the Medicare Administrative Contractor for Jurisdiction L (Delaware, the District of Columbia, Maryland, New Jersey and Pennsylvania), whose local coverage articles for therapy are the ones a Pennsylvania clinic reads.⁠⁶⁸ Medical Assistance’s adult therapy rules are in the Medicaid section above. The Department of Labor and Industry publishes Pennsylvania’s Workers’ Compensation Fee Schedule, the maximum fees allowed for medical services to injured workers, with a Part B schedule and a table for per-visit physical therapy providers. The page was updated October 1, 2026.⁠⁶⁹

Which associations and directory pages serve Pennsylvania?

The state chapters are APTA Pennsylvania for physical therapy, the Pennsylvania Occupational Therapy Association for occupational therapy and the Pennsylvania Speech-Language-Hearing Association for speech-language pathology.⁠^70,71,72 On DrSensory, families browse Pennsylvania 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.⁠⁷³

Which Pennsylvania cities have DrSensory city pages?

Beyond its three Pennsylvania pages, the directory publishes city pages for 2 Pennsylvania cities, 6 pages across the three disciplines, each listing the clinics whose address is in that city; a clinic appears on the city page of its address without any action of its own, and a city or discipline without a page is reached through the state page.⁠⁷³

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

DrSensory lists 76 PT, OT and SLP clinics in Pennsylvania, on its occupational therapy, physical therapy and speech therapy pages for the state.⁠⁷³

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

Which templates does a Pennsylvania launch need?

How might two Pennsylvania clinics plan a launch?

Sources

1. Pennsylvania. Pennsylvania State Board of Physical Therapy. Checked October 30, 2026.
2. Pennsylvania General Assembly. Physical Therapy Practice Act, Act of Oct. 10, 1975, P.L. 383, No. 110, section 9. Checked October 30, 2026.
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   “Licensees who meet the standards set forth in this subsection may apply to the board for a certificate of authorization to practice physical therapy under this act without the required referral under subsection (a). ... A physical therapist may treat an individual without a referral as provided for in subsection (b) for up to 30 days from the date of the first treatment. A physical therapist shall not treat an individual beyond 30 days from the date of the first treatment unless he or she has obtained a referral from a licensed physician; a licensed physician assistant practicing pursuant to a written agreement with a physician; a certified registered nurse practitioner practicing pursuant to a collaborative agreement with a physician; or a licensed dentist or licensed podiatrist, for the treatment of a condition that is within the scope of practice of dentistry or podiatry. ... Nothing herein shall preclude an insurer or other third-party payor from requiring that a physical therapist obtain a referral ...”
3. Pennsylvania Department of Human Services, Office of Medical Assistance Programs. Medical Assistance Bulletin 99-18-01, Revised Health Care Benefit Packages Provider Reference Chart (MA 446). Checked October 30, 2026.
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   “Therapist 17 170 Physical Therapist Y I C N I Therapist 17 171 Occupational Therapist Y I C N I Therapist 17 173 Speech/Hearing Therapist Y I C N I ... Y Yes, if medically necessary ... Beneficiaries under 21 years of age are eligible for all medically necessary MA services.”
4. Pennsylvania Department of Human Services. Medicaid for Children with Special Needs. “Medicaid for Children with Special Needs (PH95) provides full and free Medical Assistance (MA) coverage to children up to age 18 with disabilities whose parents make too much money to qualify for traditional Medicaid categories. ... Rehabilitation Services ...” Checked October 30, 2026.
5. Pennsylvania. Pennsylvania State Board of Occupational Therapy Education and Licensure. Checked October 30, 2026.
6. Pennsylvania. Pennsylvania State Board of Examiners in Speech-Language Pathology and Audiology. Checked October 30, 2026.
7. Pennsylvania Code & Bulletin. 49 Pa. Code § 40.61. Certificate of authorization to practice physical therapy without a referral.. “A certificateholder may not delegate the care of a patient being treated without a referral to a physical therapist who is not a certificateholder.” Checked October 30, 2026.
8. Pennsylvania Department of Human Services, Office of Medical Assistance Programs. Medical Assistance Bulletin 99-18-01, Revised Health Care Benefit Packages Provider Reference Chart (MA 446). Checked October 30, 2026.
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   “Therapist 17 170 Physical Therapist Y I C N I ... I For beneficiaries age 21 and older, only covered when provided by a hospital, outpatient clinic, or home health provider ...”
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. “Member States (38) ... Pennsylvania ... 38 Member States Actively Issuing and Accepting Compact Privileges ...” Checked October 30, 2026.
11. Pennsylvania Department of State, State Board of Physical Therapy. Physical Therapy Compact. “Pennsylvania fully implemented the PT Compact on July 7, 2025, and Pennsylvania physical therapists and physical therapist assistants can now apply for a compact privilege.” Checked October 30, 2026.
12. 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.
13. Audiology and Speech-Language Pathology Interstate Compact Commission. ASLPCompact. “Registration for compact privileges to practice is open for licensed practitioners in Louisiana, Ohio, Tennessee, and West Virginia.” Checked October 30, 2026.
14. 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.”.
15. Pennsylvania Code & Bulletin. 49 Pa. Code § 45.101. Preparing, maintaining and retaining records.. “A licensee shall retain records for a person served for a minimum of 7 years from the date of the last entry. A licensee shall retain and store the records in a safe location to maintain confidentiality.” Checked October 30, 2026.
16. Pennsylvania Code & Bulletin. 49 Pa. Code § 40.52. Unprofessional conduct; physical therapists.. “Failure to maintain adequate patient records. Adequate patient records include at a minimum sufficient information to identify the patient, a summary of the findings of the examination, an evaluation, a diagnosis, the plan of care including desired outcomes, and the treatment record.” Checked October 30, 2026.
17. Pennsylvania Code & Bulletin. 55 Pa. Code § 1101.51. Ongoing responsibilities of providers.. “Providers shall retain, for at least 4 years, unless otherwise specified in the provider regulations, medical and fiscal records that fully disclose the nature and extent of the services rendered to MA recipients ...” Checked October 30, 2026.
18. Pennsylvania Department of State. Business. Checked October 30, 2026.
19. Pennsylvania General Assembly. Title 15 (Corporations and Unincorporated Associations), Chapter 29, sections 2903 and 2923. Checked October 30, 2026.
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    “It is the intent of the General Assembly to authorize by this chapter licensed persons to render professional services by means of a professional corporation in all cases. (c) Single-purpose corporations.-- Except as provided in subsection (d), a professional corporation may be incorporated only for the purpose of rendering one specific kind of professional service. ... Except as otherwise provided by a statute, rule or regulation applicable to a particular profession, all of the ultimate beneficial owners of shares in a professional corporation shall be licensed persons and any issuance or transfer of shares in violation of this restriction shall be void.”
20. Pennsylvania Code & Bulletin. 49 Pa. Code § 45.203. Business entities.. Checked October 30, 2026.
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    “A business entity may provide services which require licensure, if the following conditions are met: (1) The individuals engaging in the practice of a licensed activity possess a current valid license from the Board. (2) The business entity files with the Board a certification that the business entity submits itself to the requirements of the act and the jurisdiction of the Board and this chapter.”
21. Pennsylvania Department of Human Services. Early Intervention Services. Checked October 30, 2026.
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    “Pennsylvania’s Early Intervention program provides coaching support and services to families with children, from birth to age five, with developmental delays and disabilities. ... Early Intervention services are provided at no cost to families. ... If you or a family member have a concern about a child’s development, contact Pennsylvania Statewide CONNECT. The family will be referred to a local Early Intervention program for a developmental screening and if appropriate an evaluation of the child’s development.”
22. Pennsylvania Department of Human Services. MA Fee Schedule. “The fee schedule rates have been established for Infant/Toddler Early Intervention services.” Checked October 30, 2026.
23. Pennsylvania Department of State, State Board of Physical Therapy. Physical Therapy Renewal Information. Checked October 30, 2026.
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    “Licenses expire December 31 of every even-numbered year. The Board will e-mail renewal notices approximately 60 days prior to the license expiration date. Separate notices are e-mailed for the Certificate of Authorization and Physical Therapist license, however the Certificate cannot be renewed unless the PT license of the certificate holder is concurrently renewed.”
24. Pennsylvania Code & Bulletin. 49 Pa. Code § 40.67. Continuing education for licensed physical therapist.. Checked October 30, 2026.
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    “During each biennial renewal period, a licensee shall complete qualifying continuing education equal to at least 30 contact hours of continuing physical therapy education, including at least 2 contact hours in law or ethics applicable to the practice of physical therapy, and at least 2 contact hours in child abuse recognition and reporting in accordance with § 40.208(b) (relating to child abuse recognition and reporting—mandatory training requirement). ... A licensee is not required to complete continuing education during the biennial renewal cycle in which the licensee was first licensed.”
25. Pennsylvania Code & Bulletin. 49 Pa. Code § 40.192. Continuing education for certified physical therapist assistant.. Checked October 30, 2026.
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    “During each biennial renewal period, a certified physical therapist assistant shall complete qualifying continuing education equal to at least 30 contact hours of continuing physical therapy education, including at least 4 contact hours in identifying and responding to emergency health conditions, at least 2 contact hours in law or ethics applicable to the practice of physical therapy and at least 2 contact hours in child abuse recognition and reporting ...”
26. Pennsylvania Code & Bulletin. 49 Pa. Code § 40.63. Continuing education for direct access certificateholder.. Checked October 30, 2026.
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    “Beginning after the first renewal of the certificate of authorization, as a condition of certificate renewal, a physical therapist shall have completed during the preceding biennium a minimum of 30 contact hours of physical therapy continuing education related to keeping the certificateholder apprised of advancements and new developments in the practice of the physical therapy profession. At least 10 of the 30 contact hours shall be in evaluative procedures to treat a person without a referral.”
27. Pennsylvania Code & Bulletin. 49 Pa. Code § 40.173. Supervision of physical therapist assistant by licensed physical therapist.. Checked October 30, 2026.
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    “A physical therapist assistant may provide patient care services only under the supervision of a licensed physical therapist. Except as otherwise provided in the act or this subchapter, a physical therapist assistant may provide patient care services only under the direct on-premises supervision of a licensed physical therapist. ... The performance of selected acts and services by the physical therapist assistant is the responsibility of the licensed physical therapist at all times. ... When care is provided to an individual in a preschool, primary school, secondary school or other similar educational setting, a licensed physical therapist shall make an onsite visit and examine the patient at least every four patient visits or every 30 days, whichever occurs first. (3) When care is provided to an individual in an early intervention setting, a licensed physical therapist shall make an onsite visit and examine the patient at least every four patient visits or every 30 days, whichever occurs first. (4) When care is provided to a patient in a physical therapy independent private practice outpatient facility, a licensed physical therapist shall provide direct on-premises supervision for a physical therapist assistant for at least 50% of the hours worked by the physical therapist assistant during the calendar week unless otherwise required under Federal law. The physical therapist shall be immediately available by telecommunication when not providing direct on-premises supervision.”
28. Pennsylvania Department of State, State Board of Occupational Therapy Education and Licensure. Renewal Information for the State Board of Occupational Therapy. “Licenses expire June 30 of every odd-numbered year. The renewal is an online only process on www.pals.pa.gov.” Checked October 30, 2026.
29. Pennsylvania Code & Bulletin. 49 Pa. Code § 42.16. Biennial renewal; inactive status; failure to renew.. “A license granted under the act expires on June 30 of every odd numbered year unless renewed for the next biennium.” Checked October 30, 2026.
30. Pennsylvania Code & Bulletin. 49 Pa. Code § 42.53. Continued competency requirements.. Checked October 30, 2026.
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    “Beginning with the July 1, 2013—June 30, 2015, biennium, an occupational therapist shall complete a minimum of 24 contact hours in each biennial period in acceptable continued competency activities listed in § 42.55 (relating to acceptable continued competency activities) as a condition of licensure renewal. Beginning with the July 1, 2019—June 30, 2021, biennium, an occupational therapy assistant shall complete a minimum of 24 contact hours in each biennial period in acceptable continued competency activities listed in § 42.55 as a condition of licensure renewal. At least 2 hours of the required 24 hours shall be completed in child abuse recognition and reporting in accordance with § 42.48 (relating to child abuse recognition and reporting—mandatory training requirement). ... With the limited exception of the 2 hours of mandated training in child abuse recognition and reporting, a licensee is exempt from complying with subsection (a) for the first biennial renewal period following initial licensure.”
31. Pennsylvania Code & Bulletin. 49 Pa. Code § 42.22. Supervision of occupational therapy assistants.. Checked October 30, 2026.
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    “Section 3 of the act (63 P.S. § 1503) provides that licensed occupational therapy assistants may assist in the practice of occupational therapy only under the supervision of an occupational therapist. ‘‘Under the supervision of an occupational therapist’’ means that an occupational therapist currently licensed by the Board: (1) Evaluates the patient/client. (2) Prepares a written program plan. (3) Assigns treatment duties based on that program plan to an occupational therapy assistant currently licensed by the Board who has been specifically trained to carry out those duties. (4) Monitors the occupational therapy assistant’s performance. (5) Accepts professional responsibility for the occupational therapy assistant’s performance. ... The supervisor shall have supervisory contact with the occupational therapy assistant at least 10% of the time worked by the assistant in direct patient care. ... Face-to-face individual contact shall occur onsite at least once a month and shall include observation of the assistant performing occupational therapy.”
32. Pennsylvania Department of State, State Board of Examiners in Speech-Language Pathology and Audiology. State Board of Examiners in Speech-Language Pathology and Audiology License Renewal Information. “Licenses expire July 31 of every even-numbered year. The Board will e-mail renewal notices approximately 60 days prior to the license expiration date.” Checked October 30, 2026.
33. Pennsylvania Code & Bulletin. 49 Pa. Code § 45.501. Credit hour requirements.. Checked October 30, 2026.
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    “Each speech-language pathologist or audiologist shall have completed 20 clock hours of continuing education per license during each preceding biennial period, including at least 2 hours of approved courses in child abuse recognition and reporting in accordance with § 45.408(b) (relating to child abuse recognition and reporting—mandatory training requirement). Excess clock hours may not be carried over to the next biennium.”
34. Pennsylvania Code & Bulletin. 49 Pa. Code § 45.306. Supervision and responsibility.. Checked October 30, 2026.
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    “A licensee who supervises an assistant shall be responsible for: ... (2) The assistant’s performance of assigned duties. ... (5) Directly observing the assistant’s performance in 25% of each clinical session. Direct observations shall be documented and the quality of the assistant’s performance shall be reviewed with the assistant. (6) Ensuring that persons who will be receiving services from an assistant, or the person’s legal representative, is informed that services are being rendered by an assistant. (7) Providing direct onsite supervision of the assistant.”
35. Pennsylvania Code & Bulletin. 49 Pa. Code § 45.303. Maximum number of assistants.. “A licensee may not supervise more than three assistants. This section does not apply to a licensee acting within the scope of the licensee’s employment under section 6(b)(2) of the act ...” Checked October 30, 2026.
36. Pennsylvania General Assembly. Occupational Therapy Practice Act, Act of Jun. 15, 1982, P.L. 502, No. 140, section 14. Checked October 30, 2026.
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    “An occupational therapist may enter a case for the purposes of providing indirect services, consultation, evaluating an individual as to the need for services and other occupational therapy services for conditions such as perceptual, cognitive, sensory integration and similar conditions. Implementation of direct occupational therapy to an individual for a specific medical condition shall be based on a referral from a licensed physician, licensed optometrist, licensed podiatrist, licensed certified registered nurse practitioner or licensed physician assistant.”
37. Pennsylvania Code & Bulletin. 49 Pa. Code § 42.25. Orders.. “The occupational therapist in a private office setting who has received an oral order shall obtain the countersignature of the licensed physician, licensed optometrist, licensed podiatrist, certified registered nurse practitioner or physician assistant who issued the order within 5 days of receiving the order.” Checked October 30, 2026.
38. Pennsylvania General Assembly. Speech-Language Pathologists and Audiologists Licensure Act, Act of Dec. 21, 1984, P.L. 1253, No. 238, sections 3 and 12. Checked October 30, 2026.
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    “Any person who is qualified by education, training and clinical experience and is licensed under this act to engage in the practice of speech-language pathology and is an independent practitioner providing services in hospitals, clinics, public school entities, nonpublic schools, private practices and other settings in which speech-language pathology services are relevant. ... A speech-language pathologist or audiologist shall refer patients who present with suspected medical conditions beyond the scope of practice under this act for medical evaluation to an appropriate physician within 30 days.”
39. Pennsylvania Department of Human Services. PROMISe Provider Enrollment. Checked October 30, 2026.
40. Medicaid.gov (Centers for Medicare & Medicaid Services). Early and Periodic Screening, Diagnostic, and Treatment (Medicaid benefit page). Checked October 26, 2026.
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    “The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid.”; “It is the responsibility of states to determine medical necessity on a case-by-case basis.”.
41. Pennsylvania Code & Bulletin. 55 Pa. Code Chapter 1150. MA Program Payment Policies, section 1150.58. “Prior authorization is required for those services and items so designated in the MA Program fee schedule with the prior authorization indicator (PA).” Checked October 30, 2026.
42. Pennsylvania Department of Human Services, Office of Medical Assistance Programs. Medical Assistance Bulletin 99-25-03, Updates to Screening Guidelines for Prior Authorization. Checked October 30, 2026.
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    “Effective July 18, 2025, the Department will begin to use the most current edition of MCG care guidelines for screening to determine medical necessity for the following types of covered services requiring prior authorization: ... Home care including intermittent visits for skilled nursing, home health aide, physical therapy, occupational therapy, speech pathology, and audiology services.”
43. Pennsylvania Department of Human Services. For Providers of Physical HealthChoices. Checked October 30, 2026.
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    “The Physical HealthChoices program is the name of Pennsylvania’s mandatory managed care programs for Medical Assistance recipients. Through physical health managed care organizations (MCOs), recipients receive quality medical care and timely access to all appropriate physical health services, whether the services are delivered on an inpatient or outpatient basis.”
44. Pennsylvania Department of Human Services. Statewide MCO Map. “Southeast Counties in the HealthChoices Program: Bucks, Chester, Delaware, Montgomery, Philadelphia HealthChoices Physical Health Plans ... Geisinger Health Plan ... Jefferson Health Plans EverWell ... Keystone First ... UnitedHealthcare Community Plan ... UPMC for You, Inc.” Checked October 30, 2026.
45. Pennsylvania Department of Human Services. MA Fee Schedule. Checked October 30, 2026.
46. Pennsylvania Department of Human Services. Requirements for Provider Type 17 - Therapist (May 19, 2021). “Requirements for Provider Type 17 - Therapist Specialty Code Please choose from the following for the specialty and code: 170 - Physical Therapist 171 - Occupational Therapist 173 - Speech/Hearing Therapist ...” Checked October 30, 2026.
47. Pennsylvania Department of Human Services, Office of Medical Assistance Programs. Medical Assistance Bulletin 99-18-01, Revised Health Care Benefit Packages Provider Reference Chart (MA 446). Checked October 30, 2026.
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    “Therapist 17 176 Physical Therapy / Early Intervention age 0-3 Y N C N N ... Therapist 17 177 Occupational Therapy / Early Intervention age 0-3 Y N C N N Therapist 17 178 Speech/Hearing Therapy/ Early Intervention age 0-3 Y N C N N ...”
48. Pennsylvania Department of Human Services, Office of Medical Assistance Programs. Medical Assistance Bulletin 99-23-08, Updates to Guidelines for the Delivery of Physical Health Services via Telehealth. “POS 02 when telehealth is delivered in a setting other than the individual’s home and POS 10 when telehealth is delivered in the individual’s home.” Checked October 30, 2026.
49. Pennsylvania Department of Human Services. School Based ACCESS Program (SBAP). Checked October 30, 2026.
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    “Local Education Agencies (LEAs) enrolled in the Medicaid (Medical Assistance) Program can receive reimbursement for School-Based ACCESS Program (SBAP) services for the delivery of direct health-related services to students in the school setting and for Medicaid-allowable administrative services. SBAP services can be reimbursed when provided to MA-eligible students aged 3 through 20 when documented in an Individualized Education Program (IEP) or an Individualized Family Service Plan (IFSP).”
50. Pennsylvania Department of Human Services, Office of Medical Assistance Programs. Medical Assistance Bulletin 99-23-08 (issue date August 2, 2023), Updates to Guidelines for the Delivery of Physical Health Services via Telehealth. Checked October 30, 2026.
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    “the MA Program will now utilize two Place of Service (POS) codes to identify when services are rendered via telehealth – POS 02 when telehealth is delivered in a setting other than the individual’s home and POS 10 when telehealth is delivered in the individual’s home. ... The Department will continue to allow providers to utilize audio-only telecommunication when the beneficiary does not have access to video capability or for an urgent medical situation. ... Services rendered via telehealth, including those delivered using audio-only telecommunication technology, must use technology that is two-way, real-time, and interactive between beneficiary and provider. MA services in the FFS delivery system rendered via telehealth will be paid the same rate as if the services were rendered in person.”
51. Pennsylvania General Assembly. Act of Jul. 3, 2024, P.L. 516, No. 42, Insurance (40 Pa.C.S.), Telemedicine, section 4805. “A health care provider providing health care services through telemedicine shall be subject to the same standard of care that would apply to the health care services in an in-person setting.” Checked October 30, 2026.
52. Pennsylvania Department of Human Services, Office of Medical Assistance Programs. Medical Assistance Bulletin 99-23-08, Updates to Guidelines for the Delivery of Physical Health Services via Telehealth. Checked October 30, 2026.
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    “Providers are to obtain consent prior to rendering a service via telehealth from the beneficiary receiving services or their legal guardian. Providers must also allow beneficiaries to elect to return to in-person services at any time.”
53. Pennsylvania General Assembly. Act of Jul. 3, 2024, P.L. 516, No. 42, Insurance (40 Pa.C.S.), Telemedicine, sections 4803 and 4804. Checked October 30, 2026.
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    “A health insurance policy offered, issued or renewed in this Commonwealth shall provide coverage for medically necessary health care services provided through telemedicine and delivered by a participating network provider who provides a covered health care service through telemedicine consistent with the insurer’s medical policies. A health insurance policy may not exclude a health care service from coverage solely because the health care service is provided through telemedicine. (2) Subject to paragraph (1), an insurer shall pay or reimburse a participating network provider for covered health care services delivered through telemedicine and pursuant to a health insurance policy in accordance with the terms and conditions of the contract as negotiated between the insurer and the participating network provider. ... MA or CHIP managed care plan payments shall be made on behalf of enrollees for medically necessary health care services provided through telemedicine, if all of the following apply: (i) The health care service would be covered through an in-person encounter. ... This section shall apply to MA and CHIP managed care plans beginning on or after January 1, 2026.”
54. Pennsylvania Department of Revenue. Employer Withholding. Checked October 30, 2026.
55. Pennsylvania Department of Revenue. Sales, Use and Hotel Occupancy Tax. Checked October 30, 2026.
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    “The sales and use tax is imposed on the retail sale, consumption, rental or use of tangible personal property including - digital products - in Pennsylvania. The tax is also imposed on certain services relating to such property and on the charge for specific business services. ... Sales, Use, and Hotel Occupancy Retail Tax License Required for any business that sells taxable items or performs taxable services.”
56. Pennsylvania Department of Revenue. Retailer’s Information, REV-717 (SU) 02-26. Checked October 30, 2026.
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    “The tax is not imposed on prescription or nonprescription medicines and drugs or medical supplies, crutches and wheelchairs for the use of people with disabilities, artificial limbs, artificial eyes and artificial hearing devices, when designed to be worn on the person of the purchaser or user, ... and artificial braces and supports designed solely for the use of people with disabilities, or any other therapeutic, prosthetic or artificial device designed for the use of a particular individual to correct or alleviate a physical incapacity, including, but not limited to, hospital beds, iron lungs and kidney machines.”
57. Pennsylvania General Assembly. Workers’ Compensation Act, Act of Jun. 2, 1915, P.L. 736, No. 338, section 305. Checked October 30, 2026.
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    “Every employer liable under this act to pay compensation shall insure the payment of compensation in the State Workmen’s Insurance Fund, or in any insurance company, or mutual association or company, authorized to insure such liability in this Commonwealth, unless such employer shall be exempted by the department from such insurance.”
58. 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.”.
59. 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.”.
60. Pennsylvania General Assembly. Breach of Personal Information Notification Act, Act of Dec. 22, 2005, P.L. 474, No. 94, section 3. Checked October 30, 2026.
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    “An entity that maintains, stores or manages computerized data that includes personal information shall provide notice of any breach of the security of the system following determination of the breach of the security of the system to any resident of this Commonwealth whose unencrypted and unredacted personal information was or is reasonably believed to have been accessed and acquired by an unauthorized person. Except as provided in section 4 or in order to take any measures necessary to determine the scope of the breach and to restore the reasonable integrity of the data system, the notice shall be made without unreasonable delay. ... When notice of the breach of the security of the system under this section must be given to more than 500 affected individuals in this Commonwealth, notice shall be made concurrently to the Office of Attorney General.”
61. Pennsylvania General Assembly. Breach of Personal Information Notification Act, Act of Dec. 22, 2005, P.L. 474, No. 94, section 5.3. Checked October 30, 2026.
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    “Any covered entity or business associate that is subject to and in compliance with the privacy and security standards for the protection of electronic personal health information established under the Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191, 110 Stat. 1936) and the Health Information Technology for Economic and Clinical Health Act (Public Law 111-5, 123 Stat. 226-279 and 467-496) shall be deemed to be in compliance with the provisions of this act.”
62. Pennsylvania General Assembly. Title 23 (Domestic Relations), Chapter 63, section 6311. Checked October 30, 2026.
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    “The following adults shall make a report of suspected child abuse, subject to subsection (b), if the person has reasonable cause to suspect that a child is a victim of child abuse: (1) A person licensed or certified to practice in any health-related field under the jurisdiction of the Department of State.”
63. Pennsylvania Department of State. Boards & Commissions. “Bureau of Professional and Occupational Affairs provides administrative and legal support to 29 professional and occupational licensing boards and commissions. ... Occupational Therapy ... Physical Therapy ... Speech-Language Pathology and Audiology ...” Checked October 30, 2026.
64. Pennsylvania Code & Bulletin. 49 Pa. Code § 40.67. Continuing education for licensed physical therapist.. Checked October 30, 2026.
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    “During each biennial renewal period, a licensee shall complete qualifying continuing education equal to at least 30 contact hours of continuing physical therapy education, including at least 2 contact hours in law or ethics applicable to the practice of physical therapy, and at least 2 contact hours in child abuse recognition and reporting in accordance with § 40.208(b) (relating to child abuse recognition and reporting—mandatory training requirement).”
65. Pennsylvania Code & Bulletin. 49 Pa. Code § 42.53. Continued competency requirements.. “At least 2 hours of the required 24 hours shall be completed in child abuse recognition and reporting in accordance with § 42.48 (relating to child abuse recognition and reporting—mandatory training requirement).” Checked October 30, 2026.
66. Pennsylvania Code & Bulletin. 49 Pa. Code § 45.501. Credit hour requirements.. Checked October 30, 2026.
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    “Each speech-language pathologist or audiologist shall have completed 20 clock hours of continuing education per license during each preceding biennial period, including at least 2 hours of approved courses in child abuse recognition and reporting in accordance with § 45.408(b) (relating to child abuse recognition and reporting—mandatory training requirement).”
67. Pennsylvania General Assembly. The Insurance Company Law of 1921, Act of May 17, 1921, P.L. 682, No. 284, section 635.2. Checked October 30, 2026.
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    “A health insurance policy or government program covered under this section shall provide to covered individuals or recipients under twenty-one (21) years of age coverage for the diagnostic assessment of autism spectrum disorders and for the treatment of autism spectrum disorders. (b) Coverage provided under this section by an insurer shall be subject to a maximum benefit of thirty-six thousand dollars ($36,000) per year but shall not be subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. After December 30, 2011, the Insurance Commissioner shall, on or before April 1 of each calendar year, publish in the Pennsylvania Bulletin an adjustment to the maximum benefit ... This section shall apply to any health insurance policy offered, issued or renewed on or after July 1, 2009, in this Commonwealth to groups of fifty-one (51) or more employees ... "Therapeutic care" means services provided by speech language pathologists, occupational therapists or physical therapists.”
68. Novitas Solutions. Medicare JL Home. “Medicare JL ... Providers in DC, DE, MD, NJ & PA ... Medicare: Jurisdiction L website ...” Checked October 30, 2026.
69. Pennsylvania Department of Labor and Industry. Workers’ Compensation Fee Schedule. Checked October 30, 2026.
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    “Workers’ compensation fee schedules are a set of guidelines that show the maximum fees that are allowed to be charged for medical services provided to injured workers under the workers’ compensation system in Pennsylvania. Web Page Updated: 10/1/2026 ... Table G: Physical Therapy Per Visit Based Provider & OP End Stage Renal Dialysis Table ...”
70. APTA Pennsylvania. APTA Pennsylvania (the state association's site). Checked October 30, 2026.
71. the Pennsylvania Occupational Therapy Association. the Pennsylvania Occupational Therapy Association (the state association's site). Checked October 30, 2026.
72. the Pennsylvania Speech-Language-Hearing Association. the Pennsylvania Speech-Language-Hearing Association (the state association's site). Checked October 30, 2026.
73. DrSensory. Occupational therapy clinics in Pennsylvania, 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.
74. 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 Pennsylvania, not legal, compliance, billing or financial advice. Rules change; the clinic confirms each with its source before acting on it.