Virginia PT, OT and SLP guide

For OT, PT and SLP clinics in Virginia: three state boards license the disciplines, a physical therapist with an accredited doctor of physical therapy degree or the board’s certificate of authorization may treat without a referral, Virginia Medicaid covers children’s therapy under EPSDT and adults within its own rules, and telehealth follows the patient’s location.⁠^1,2,3,4

Who licenses OTs, PTs and SLPs in Virginia?

Three state boards license the three disciplines in Virginia, 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 Virginia Board of Physical Therapy.⁠^{1,31,32,33,34,35} Occupational therapists and occupational therapy assistants answer to the Virginia Board of Medicine, with its Advisory Board of Occupational Therapy.⁠^{5,36,37,38,39,40} Speech-language pathologists answer to the Virginia Board of Audiology and Speech-Language Pathology.⁠^{6,41,42,43,44} The Board of Medicine, not a separate occupational therapy board, licenses occupational therapists and occupational therapy assistants, and an Advisory Board of Occupational Therapy assists it.⁠^{5,36,37,38,39,40} 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 Virginia 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 Virginia 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 has completed a doctor of physical therapy program approved by the Commission on Accreditation of Physical Therapy Education, or who holds the board’s certificate of authorization, may evaluate and treat a patient without a referral; when the patient is already receiving care for the same symptoms from a doctor, an advanced practice registered nurse or a physician assistant, the patient identifies that practitioner and gives written consent to release records, and the physical therapist notifies the practitioner no later than 14 days after treatment commences, with a copy of the initial evaluation and the patient history; a physical therapist with neither credential may conduct a one-time evaluation that does not include treatment without a referral; no referral is needed for infants and toddlers receiving physical therapy under their Part C individualized services plan or for students with disabilities under their individualized education plan or section 504.⁠^2,7,8,9 For occupational therapy, the Code of Virginia defines the practice of occupational therapy as the therapeutic use of occupations for habilitation and rehabilitation, including evaluation, orthoses, adaptive equipment and consultation on physical, sensory and social environments, and makes it unlawful to practice occupational therapy or work as an occupational therapy assistant without a current and valid license from the Board of Medicine.⁠^45,46,47 For speech-language pathology, the licensure act defines the practice of speech-language pathology as facilitating the development and maintenance of human communication through screening, identifying, assessing and interpreting, diagnosing, habilitating and rehabilitating speech-language disorders, and requires a valid license to practice it.⁠^48,49,50 Virginia Medicaid, as a payer, requires a physician or other licensed practitioner of the healing arts, such as a nurse practitioner or a physician assistant, to prescribe outpatient rehabilitation services.⁠⁹

The payer’s rule is separate. Medicare pays for outpatient therapy under a plan of care certified by a physician or nonphysician practitioner, and the regulation’s 2025 text lets a signed order or referral on file, with the plan delivered within 30 days of the initial evaluation, stand in for that signature on an initial plan.⁠²⁰ Virginia 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 Virginia Medicaid pay for pediatric and adult therapy?

Virginia Medicaid is run by the Department of Medical Assistance Services (DMAS), and a clinic enrolls through its provider enrollment route before it bills.⁠⁵¹ 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.⁠⁵² Under EPSDT, Virginia Medicaid covers medically necessary services that correct or ameliorate a child’s condition even where the same service is optional or limited for adults, and a request for a child under 21 that is first denied gets a secondary review under the EPSDT provision. The Rehabilitation manual also covers rehabilitation services for speech impairments secondary to developmental delays, autism and other related communication disorders.⁠^3,4

Inpatient and outpatient rehabilitation services are covered for the entire Medicaid population, and physical therapy, occupational therapy or speech therapy may each be offered as the only rehabilitative service.⁠¹⁰ Outpatient physical therapy, occupational therapy and speech-language pathology are limited to five visits per discipline a year, July 1 through June 30, initial evaluations included, without service authorization. More visits need service authorization through Acentra Health, and for a member enrolled in managed care the provider contacts the member’s MCO.⁠^53,54 Most Virginia Medicaid members must enroll in managed care, through Cardinal Care managed care organizations that each cover the whole state: Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Humana Healthy Horizons of Virginia, Sentara Health Plans and UnitedHealthcare Community Plan. A clinic enrolls with DMAS and contracts with each plan individually.⁠^55,56 The fee schedule is published by the agency, and a clinic reads the current file rather than a remembered rate.⁠⁵⁷

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

Outpatient rehabilitation is reimbursed per visit. In-state private rehabilitation agencies, CORFs and physician providers request service authorization with the CPT codes Appendix D lists, where 97110 and 97530 count one unit as 15 minutes, and in-state general and rehabilitation hospitals use revenue codes.⁠^{58,59,60,61,62,63} 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 Virginia Medicaid pay for therapy in schools?

School-based services, physical therapy, occupational therapy and speech-language therapy among them, are covered under EPSDT, provided by local education agencies to children enrolled in Medicaid and FAMIS, billed by the LEA through DMAS’s school-based interim claiming process, carved out of managed care and reimbursed on a cost basis.⁠⁶⁴ 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 Virginia Medicaid cover therapy by telehealth?

The Telehealth Services Supplement lists speech-language therapy codes 92507, 92508 and 92521 and up, and physical and occupational therapy codes 97110, 97112, 97150, 97530 and S9129, among services covered by telemedicine, which must meet the same standard of care as in person. Claims use place of service 02, or 10 when the member is at home, and the distant site provider adds the GT modifier.⁠^65,66 The telehealth section below covers the state’s own rules for the session itself.

What are Virginia’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.⁠¹¹ The Board of Physical Therapy’s telehealth guidance treats physical therapy by telehealth as practiced where the client is located, so the practitioner must be licensed by, or under the jurisdiction of, that state’s board, and calls for documented informed consent. The Board of Audiology and Speech-Language Pathology’s guidance requires a Virginia license to serve a client in Virginia by telepractice and holds telepractice to the same standard of care as in-person service.⁠^67,68,69

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.⁠^12,13,14 Section 38.2-3418.16 requires insurers, corporations providing subscription contracts and health maintenance organizations to cover health care services provided through telemedicine, bars excluding a service solely because it is provided through telemedicine rather than face to face, and requires reimbursing the treating provider on the same basis as the same service provided face to face. Telemedicine services here do not include an audio-only telephone call.⁠⁷⁰

Which business steps are specific to Virginia?

The entity is registered with the State Corporation Commission’s Office of the Clerk, through its Clerk’s Information System (CIS), and the choice of entity is shaped by the state’s rule on who may own a therapy business.⁠²⁵ Virginia’s Professional Corporation Act limits professional services to the personal services of the professions it lists, physical therapists and physical therapist assistants and audiologists or speech pathologists among them, and the members of a professional limited liability company must be licensed or otherwise legally authorized to render the same professional services, at least one of them within the Commonwealth.⁠^26,27 State tax registration is with Virginia Tax, through its online business registration.⁠⁷¹ Virginia’s retail sales and use tax applies to the sale, lease and rental of tangible personal property, accommodations and certain taxable services unless an exemption or exception is established, and section 58.1-609.5 exempts professional or personal service transactions that involve sales only as inconsequential elements for which no separate charges are made.⁠^72,73 Virginia requires an employer that regularly employs more than two part-time or full-time employees to carry workers’ compensation, counting executive officers and the employees of subcontractors hired for the same trade, business or occupation, and every employer subject to the act must insure payment of compensation.⁠^74,75 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 Virginia?

All three Virginia boards require a PT, OT or SLP who is self-employed, or who owns and is responsible for the patient records, to keep each record at least six years after the last patient encounter, and a minor’s record until the child reaches 18 or is emancipated, with six years from the last encounter as the minimum. A practitioner employed by an institution, school system or other entity that keeps the records follows that employer’s policies.⁠^21,22,23,24 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.⁠^76,77

Section 32.1-127.1:03 recognizes an individual’s right of privacy in the content of his or her health records and bars a health care entity, or another person working in a health care setting, from disclosing them except as that section or other state law permits or requires. The physical therapy board’s records rule requires practitioners to comply with it.⁠^78,79 Section 18.2-186.6 requires an individual or entity that owns or licenses computerized data that includes personal information to disclose a breach to the Office of the Attorney General and every affected Virginia resident without unreasonable delay when unencrypted or unredacted personal information was, or is reasonably believed to have been, accessed and acquired by an unauthorized person and causes, or is reasonably believed to cause, identity theft or another fraud.⁠⁸⁰ Virginia’s adult protective services law requires any person licensed, certified or registered by a health regulatory board listed in section 54.1-2503, a list that includes the Board of Physical Therapy, the Board of Medicine and the Board of Audiology and Speech-Language Pathology, to report suspected abuse, neglect or exploitation of an aged or incapacitated adult. The child abuse reporting law requires the persons it lists, among them anyone licensed to practice medicine or any of the healing arts and any person employed in the nursing profession, to report a suspected abused or neglected child immediately.⁠^81,82,83

Which Virginia rules shape a pediatric clinic?

The Infant & Toddler Connection of Virginia is the Commonwealth’s Part C early intervention system for infants and toddlers with developmental delays or disabilities and their families, with DBHDS as lead agency and supports and services available to all eligible children regardless of a family’s ability to pay. A family, or a physician or hospital, refers a child to one of the forty local systems that make it up.⁠^28,29,30 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. Virginia’s autism coverage law requires insurers, corporations providing subscription contracts and health maintenance organizations to cover the diagnosis and treatment of autism spectrum disorder in individuals of any age from January 1, 2020. Treatment includes therapeutic care, the services of licensed or certified speech therapists, occupational therapists, physical therapists or clinical social workers, and applied behavior analysis carries an annual maximum benefit of $35,000 unless the plan elects to cover more.⁠⁸⁴ The autism insurance mandates guide covers how such a mandate meets a plan’s own terms. Care Connection for Children, the Virginia Department of Health’s statewide network for children and youth with special health care needs from birth to 21, manages a pool of funds that helps pay for certain services, therapies among them, for uninsured or underinsured families with gross income at or below 300 percent of the Federal Poverty Level, with preauthorization required.⁠⁸⁵

Which Virginia rules shape an adult clinic?

Medicare claims from Virginia go to Palmetto GBA, the Medicare Administrative Contractor for Jurisdiction M, Part A and Part B (North Carolina, South Carolina, Virginia and West Virginia), whose local coverage articles for therapy are the ones a Virginia clinic reads.⁠^86,87 Part B claims from Arlington and Fairfax counties and the city of Alexandria go to Novitas Solutions, Jurisdiction L.⁠^86,87 Virginia Medicaid’s adult therapy rules are in the Medicaid section above. The Virginia Workers’ Compensation Commission’s 2026 medical fee schedules set a fixed maximum fee per unit for the physical medicine and rehabilitation codes in Table Z when the services are provided outside a hospital, with the Hospital Outpatient Facility schedule applying in a hospital, and they count physical therapists, occupational therapists and speech therapists among the non-physician practitioners reimbursed under the maximum fee rules.⁠^88,89

Which associations and directory pages serve Virginia?

The state chapters are the Virginia Physical Therapy Association (VPTA) for physical therapy, the Virginia Occupational Therapy Association (VOTA) for occupational therapy and the Speech-Language-Hearing Association of Virginia (SHAV) for speech-language pathology.⁠^90,91,92 On DrSensory, families browse Virginia 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.⁠⁹³

Which Virginia cities have DrSensory city pages?

Beyond its three Virginia pages, the directory publishes city pages for 6 Virginia cities, 16 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.⁠⁹³

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

DrSensory lists 122 PT, OT and SLP clinics in Virginia, on its occupational therapy, physical therapy and speech therapy pages for the state.⁠⁹³

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

Which templates does a Virginia launch need?

How might two Virginia clinics plan a launch?

Sources

1. Virginia Department of Health Professions. Virginia Board of Physical Therapy. Checked October 30, 2026.
2. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-3482. Practice of physical therapy; certain experience and referrals required; physical therapist assistants. Checked October 30, 2026.
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   “A. It shall be unlawful for a person to engage in the practice of physical therapy except as a licensed physical therapist, upon the referral and direction of a licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental surgery, a licensed advanced practice registered nurse practicing in accordance with the provisions of § 54.1-2957, or a licensed physician assistant acting under the supervision of a licensed physician, except as provided in this section. B. A physical therapist who has completed a doctor of physical therapy program approved by the Commission on Accreditation of Physical Therapy Education or who has obtained a certificate of authorization pursuant to § 54.1-3482.1 may evaluate and treat a patient without a referral under the following conditions: ... (a) the patient identifies a licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental surgery, a licensed advanced practice registered nurse practicing in accordance with the provisions of § 54.1-2957, or a licensed physician assistant acting under the supervision of a licensed physician from whom he is currently receiving care; (b) the patient gives written consent for the physical therapist to release all personal health information and treatment records to the identified practitioner; and (c) the physical therapist notifies the practitioner identified by the patient no later than 14 days after treatment commences and provides the practitioner with a copy of the initial evaluation along with a copy of the patient history obtained by the physical therapist. C. A physical therapist who has not completed a doctor of physical therapy program approved by the Commission on Accreditation of Physical Therapy Education or who has not obtained a certificate of authorization pursuant to § 54.1-3482.1 may conduct a one-time evaluation that does not include treatment of a patient without the referral and direction of ... (iii) infants and toddlers, from birth to age three, who require physical therapy services to fulfill the provisions of their individualized services plan under Part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.) and students with disabilities who require physical therapy services to fulfill the provisions of their individualized education plan or physical therapy services provided under § 504 of the federal Rehabilitation Act of 1973 ...”
3. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Appendix D: Service Authorization (revision date September 24, 2026). Checked October 30, 2026.
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   “2. EPSDT also compels state Medicaid agencies to cover other services, products, or procedures for children, if those items are determined to be medically necessary to “correct or ameliorate” [make better] a defect, physical or mental illness, or condition [health problem] identified through routine medical screening or examination, regardless of whether coverage for the same service/support is an optional or limited service for adults under the state plan. ... All Medicaid and FAMIS Plus services that are currently service authorized by the Srv Auth contractor are services that can potentially be accessed by children under the age of 21. However, in addition to the traditional review, children who are initially denied services under Medicaid and FAMIS Plus require a secondary review due to the EPSDT provision.”
4. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Chapter IV: Covered Services and Limitations (revision date December 29, 2023). “Rehabilitation services for speech impairments secondary to developmental delays, autism, and other related communication disorders are also covered services.” Checked October 30, 2026.
5. Virginia Department of Health Professions. Virginia Board of Medicine, with its Advisory Board of Occupational Therapy. Checked October 30, 2026.
6. Virginia Department of Health Professions. Virginia Board of Audiology and Speech-Language Pathology. Checked October 30, 2026.
7. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-3482. Practice of physical therapy; certain experience and referrals required; physical therapist assistants. Checked October 30, 2026.
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   “(ii) the patient is receiving care from a licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental surgery, a licensed advanced practice registered nurse practicing in accordance with the provisions of § 54.1-2957, or a licensed physician assistant acting under the supervision of a licensed physician at the time of his presentation to the physical therapist for the symptoms giving rise to the presentation for physical therapy services ...”
8. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-3482.1. Certain certification required. Checked October 30, 2026.
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   “B. The minimum education, training, and experience requirements for certification shall include evidence that the applicant has successfully completed (i) a transitional program in physical therapy as recognized by the Board or (ii) at least three years of active practice with evidence of continuing education relating to carrying out direct access duties under § 54.1-3482.”
9. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Chapter IV: Covered Services and Limitations (revision date December 29, 2023). Checked October 30, 2026.
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   “In addition to the InterQual criteria requirements, eligibility for general outpatient rehabilitative services is based on the individual’s medical need for one or more of the following covered services: physical therapy, occupational therapy, or speech- language pathology services. A physician or other licensed practitioner of the healing arts, such as a nurse practitioner or a physician assistant, within the scope of his/her practice under State law, must prescribe these services.”
10. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Chapter IV: Covered Services and Limitations (revision date December 29, 2023). Checked October 30, 2026.
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    “COVERED SERVICES Inpatient and outpatient rehabilitation services are covered services available to the entire Medicaid population. ... Any one of these therapy services (PT, OT or Speech) may be offered as the sole rehabilitative service and shall not be contingent upon the provision of another service.”
11. 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”.
12. PT Compact Commission. PT Compact Map. “Member States (38) ... Utah Vermont Virginia Washington ...” Checked October 30, 2026.
13. Virginia Department of Health Professions. Virginia Board of Physical Therapy - PT Licensure Compact. “As a reminder, all compact privileges expire on the same date as your home state license. If Virginia is your home state, then your compact privileges are set to expire on December 31 of even numbered years.” Checked October 30, 2026.
14. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-3485. Form of compact; declaration of purpose. Checked October 30, 2026.
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    “A. The General Assembly hereby enacts, and the Commonwealth of Virginia hereby enters into, the Physical Therapy Licensure Compact with any and all jurisdictions legally joining therein according to its terms, in the form substantially as follows.”
15. 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. ... State Accepting OT Applications? ... Virginia March 20, 2026 not required VA OT Practice Act ...” Checked October 30, 2026.
16. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2956.7:1. Occupational Therapy Interjurisdictional Licensure Compact. Checked October 30, 2026.
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    “The General Assembly hereby enacts, and the Commonwealth of Virginia hereby enters into, the Occupational Therapy Interjurisdictional Licensure Compact with any and all states legally joining therein according to its terms, in the form substantially as follows ...”
17. Audiology and Speech-Language Pathology Interstate Compact Commission. Delegate Information. “Member State Appointed Delegates ... Virginia Audiology Bethany Rose Virginia SLP Jennifer Radford Gay ...” Checked October 30, 2026.
18. Audiology and Speech-Language Pathology Interstate Compact Commission. ASLP-IC Home. “Registration for compact privileges to practice is open for licensed practitioners in Louisiana, Ohio, Tennessee, and West Virginia. As more member states launch, the ASLP-IC Home Page and Compact Map will be updated.” Checked October 30, 2026.
19. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2606. Audiology and Speech-Language Pathology Interstate Compact; purpose. Checked October 30, 2026.
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    “The General Assembly hereby enacts, and the Commonwealth of Virginia hereby enters into, the Audiology and Speech-Language Pathology Interstate Compact with any and all states legally joining therein according to its terms, in the form substantially as follows ...”
20. 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.”.
21. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC112-20-160. Requirements for patient records.. Checked October 30, 2026.
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    “E. Practitioners who are self-employed or employed by an entity in which the individual practitioner does own and is responsible for patient records shall: 1. Maintain a patient record for a minimum of six years following the last patient encounter with the following exceptions: a. Records of a minor child shall be maintained until the child reaches the age of 18 or becomes emancipated, with a minimum time for record retention of six years from the last patient encounter regardless of the age of the child ...”
22. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC112-20-160. Requirements for patient records.. Checked October 30, 2026.
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    “D. Practitioners who are employed by a health care institution, school system or other entity, in which the individual practitioner does not own or maintain his own records, shall maintain patient records in accordance with the policies and procedures of the employing entity.”
23. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC85-80-140. Patient records.. Checked October 30, 2026.
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    “E. Practitioners who are self-employed or employed by an entity in which the individual practitioner does own and is responsible for patient records shall maintain a patient record for a minimum of six years following the last patient encounter with the following exceptions: 1. Records of a minor child, including immunizations, shall be maintained until the child reaches 18 years of age or becomes emancipated, with a minimum time for record retention of six years from the last patient encounter regardless of the age of the child ...”
24. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC30-21-141. Recordkeeping.. Checked October 30, 2026.
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    “2. For licensees who are self-employed or employed by an entity in which the individual practitioner does own and is responsible for client records, maintain a client record for a minimum of six years following the last client encounter with the following exceptions: a. For records of a minor child, the minimum time is six years from the last client encounter or until the child reaches 18 years of age or becomes emancipated, whichever is longer ...”
25. Virginia State Corporation Commission. Virginia SCC - Business Home. “The Clerk’s Information System (CIS) is Virginia’s online resource for registering and managing your business.” Checked October 30, 2026.
26. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 13.1-543. Definitions. Checked October 30, 2026.
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    “"Professional service" means any type of personal service to the public that requires as a condition precedent to the rendering of such service or use of such title the obtaining of a license, certification, or other legal authorization and shall be limited to the personal services rendered by pharmacists, optometrists, physical therapists and physical therapist assistants, practitioners of the healing arts, advanced practice registered nurses, practitioners of the behavioral science professions, veterinarians, surgeons, dentists, architects, professional engineers, land surveyors, landscape architects, certified interior designers, public accountants, certified public accountants, attorneys-at-law, insurance consultants, and audiologists or speech pathologists.”
27. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 13.1-1103. Who may become a member. Checked October 30, 2026.
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    “One or more individuals or professional business entities (i) duly licensed or otherwise legally authorized to render the same professional services other than those of architects, professional engineers or land surveyors, or to use a title other than those of certified landscape architects or certified interior designers, of which at least one is duly licensed or otherwise legally authorized to render such professional services within the Commonwealth ... may become members of a limited liability company for pecuniary profit under the provisions of Chapter 12 (§ 13.1-1000 et seq.) of this title, for the sole and specific purpose of rendering the same and specific professional service ...”
28. Infant & Toddler Connection of Virginia (Virginia Department of Behavioral Health and Developmental Services). Infant & Toddler Connection of Virginia. Checked October 30, 2026.
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    “Welcome to the Infant & Toddler Connection of Virginia, the Commonwealth’s early intervention system for infants and toddlers with developmental delays or disabilities and their families. Any infant or toddler in Virginia who isn’t developing as expected or who has a medical condition that can delay typical development is eligible to receive early intervention supports and services under Part C of the Individuals with Disabilities Education Act (IDEA). ... The Infant & Toddler Connection of Virginia’s supports and services are available to all eligible children and their families regardless of a family’s ability to pay. The Virginia Department of Behavioral Health and Developmental Services (DBHDS) has proudly served as the Lead Agency for Virginia’s implementation of Part C of the Individuals with Disabilities Education Act (IDEA) since 1987.”
29. Infant & Toddler Connection of Virginia (Virginia Department of Behavioral Health and Developmental Services). Getting Started in Early Intervention. Checked October 30, 2026.
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    “Your family’s journey within Virginia’s early intervention system begins with a referral to one of the forty local systems that together form the Infant & Toddler Connection of Virginia. Some families make their own referral to the local system. For other families, the referral is made by a physician or a hospital.”
30. Virginia Department of Medical Assistance Services. Early Intervention Services Manual, Chapter IV: Covered Services and Limitations (revision date September 16, 2024). Checked October 30, 2026.
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    “Children (0-3 years of age) who are enrolled with Medicaid/ FAMIS Plus, or FAMIS and receive services through the fee-for-service or managed care programs may be evaluated for eligibility for EI services through the Infant & Toddler Connection of Virginia.”
31. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC112-20-130. Biennial renewal of license.. Checked October 30, 2026.
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    “A. A physical therapist or physical therapist assistant who intends to continue practice shall renew his license biennially by December 31 in each even-numbered year and pay to the board the renewal fee prescribed in 18VAC112-20-27. ... C. In order to renew an active license, a licensee shall be required to: 1. Complete a minimum of 320 hours of active practice in the preceding four years; and 2. Comply with continuing competency requirements set forth in 18VAC112-20-131.”
32. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC112-20-131. Continued competency requirements for renewal of an active license.. Checked October 30, 2026.
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    “A. In order to renew an active license biennially, a physical therapist or a physical therapist assistant shall complete at least 30 contact hours of continuing learning activities within the two years immediately preceding renewal. ... 1. A minimum of 20 of the contact hours required for physical therapists and 15 of the contact hours required for physical therapist assistants shall be in Type 1 courses. ... C. A licensee shall be exempt from the continuing competency requirements for the first biennial renewal following the date of initial licensure by examination in Virginia.”
33. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC112-20-90. General responsibilities.. Checked October 30, 2026.
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    “C. A physical therapist assistant may assist the physical therapist in performing selected components of physical therapy intervention to include treatment, measurement, and data collection but not to include the performance of an evaluation as defined in 18VAC112-20-10. D. A physical therapist assistant’s encounters with a patient may be made under general supervision.”
34. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-3482. Practice of physical therapy; certain experience and referrals required; physical therapist assistants. “F. Any person licensed as a physical therapist assistant shall perform his duties only under the direction and control of a licensed physical therapist.” Checked October 30, 2026.
35. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC112-20-10. Definitions.. “"General supervision" means a physical therapist shall be available for consultation.” Checked October 30, 2026.
36. Virginia Department of Health Professions. Virginia Board of Medicine - Regulated Professions. “The following professions are regulated by the Virginia Board of Medicine ... Occupational Therapist Occupational Therapy Assistant ...” Checked October 30, 2026.
37. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2956.2. Advisory Board of Occupational Therapy. “The Advisory Board of Occupational Therapy, referred to hereinafter as "Advisory Board," shall assist the Board in the manner set forth in this chapter.” Checked October 30, 2026.
38. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC85-80-70. Biennial renewal of licensure.. Checked October 30, 2026.
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    “A. An occupational therapist or an occupational therapy assistant shall renew his license biennially during his birth month in each even-numbered year by: 1. Paying to the board the renewal fee prescribed in 18VAC85-80-26; and 2. Attesting to completion of continued competency requirements as prescribed in 18VAC85-80-71.”
39. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC85-80-71. Continued competency requirements for renewal of an active license.. Checked October 30, 2026.
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    “A. In order to renew an active license biennially, a licensee shall complete at least 10 contact hours of continuing learning activities, which shall consist of an organized program of study, classroom experience, or similar educational experience that is related to a licensee’s current or anticipated roles and responsibilities in occupational therapy and approved or provided by one of the following organizations or any of its components: ... D. A licensee shall be exempt from the continuing competency requirements for the first biennial renewal following the date of initial licensure in Virginia.”
40. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC85-80-110. Supervisory responsibilities of an occupational therapist.. Checked October 30, 2026.
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    “2. An occupational therapist shall not delegate the discretionary aspects of the initial assessment, evaluation or development of a treatment plan for a patient nor shall he delegate any task requiring a clinical decision or the knowledge, skills, and judgment of a licensed occupational therapist. ... The occupational therapist providing clinical supervision shall meet with the occupational therapy assistant to review and evaluate treatment and progress of the individual patients at least once every tenth treatment session or 30 calendar days, whichever occurs first. ... C. An occupational therapist may provide clinical supervision for up to six occupational therapy personnel, to include no more than three occupational therapy assistants at any one time.”
41. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC30-21-90. Renewal requirements.. “A. A person who desires to renew his license shall, not later than June 30 of each year, submit the renewal notice and applicable renewal fee.” Checked October 30, 2026.
42. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC30-21-100. Continuing education requirements for renewal of an active license.. Checked October 30, 2026.
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    “A. In order to renew an active license, a licensee shall complete at least 10 hours of continuing education prior to the renewal date each year. ... C. If the licensee is dually licensed by the board as an audiologist and speech-language pathologist, a total of no more than 15 hours of continuing education are required for renewal of both licenses with a minimum of 7.5 contact hours in each profession. D. A licensee shall be exempt from the continuing education requirements for the first renewal following the date of initial licensure in Virginia under 18VAC30-21-60.”
43. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC30-21-140. Supervisory responsibilities; supervision of unlicensed assistants.. Checked October 30, 2026.
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    “1. The practice of an assistant shall only be supervised by a speech-language pathologist who retains full legal and ethical responsibility for the client. A speech-language pathologist shall only supervise the equivalent of two full-time assistants. 2. The speech-language pathologist shall provide the level of supervision to the speech-language pathologist assistant necessary to ensure quality of care to include onsite supervision of at least two client sessions for each assistant being supervised every 30 days to directly observe and evaluate the performance of the assistant.”
44. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2620. (Effective July 1, 2027) License; application; qualifications of speech-language pathology assistants. Checked October 30, 2026.
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    “§ 54.1-2620. (Effective July 1, 2027) License; application; qualifications of speech-language pathology assistants. A. No person shall practice as a speech-language pathology assistant unless he possesses a current, active, and valid license from the Board. The licensee shall have the right to practice as a speech-language pathology assistant in the Commonwealth for the period of his license as set by the Board, under the supervision and direction of a licensed speech-language pathologist.”
45. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2956.5. Unlawful to practice occupational therapy without license. Checked October 30, 2026.
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    “A. It shall be unlawful for any person not holding a current and valid license from the Board to practice occupational therapy or to claim to be an occupational therapist ... B. It shall be unlawful for any person to practice as an occupational therapy assistant as defined in § 54.1-2900 or to hold himself out to be or advertise that he is an occupational therapy assistant or use the designation "O.T.A." or any variation thereof unless such person holds a current and valid license from the Board to practice as an occupational therapy assistant.”
46. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2900. Definitions. Checked October 30, 2026.
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    “"Practice of occupational therapy" means the therapeutic use of occupations for habilitation and rehabilitation to enhance physical health, mental health, and cognitive functioning and includes the evaluation, analysis, assessment, and delivery of education and training in basic and instrumental activities of daily living; the design, fabrication, and application of orthoses (splints); the design, selection, and use of adaptive equipment and assistive technologies; therapeutic activities to enhance functional performance; vocational evaluation and training; and consultation concerning the adaptation of physical, sensory, and social environments.”
47. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Chapter IV: Covered Services and Limitations (revision date December 29, 2023). Checked October 30, 2026.
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    “In addition to the InterQual criteria requirements, eligibility for general outpatient rehabilitative services is based on the individual’s medical need for one or more of the following covered services: physical therapy, occupational therapy, or speech- language pathology services. A physician or other licensed practitioner of the healing arts, such as a nurse practitioner or a physician assistant, within the scope of his/her practice under State law, must prescribe these services.”
48. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2603. License required. “A. In order to practice audiology or speech pathology, it shall be necessary to hold a valid license.” Checked October 30, 2026.
49. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2600. Definitions. “"Practice of speech-language pathology" means the practice of facilitating development and maintenance of human communication through programs of screening, identifying, assessing and interpreting, diagnosing, habilitating and rehabilitating speech-language disorders, including but not limited to ...” Checked October 30, 2026.
50. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Chapter IV: Covered Services and Limitations (revision date December 29, 2023). Checked October 30, 2026.
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    “In addition to the InterQual criteria requirements, eligibility for general outpatient rehabilitative services is based on the individual’s medical need for one or more of the following covered services: physical therapy, occupational therapy, or speech- language pathology services. A physician or other licensed practitioner of the healing arts, such as a nurse practitioner or a physician assistant, within the scope of his/her practice under State law, must prescribe these services.”
51. Virginia Department of Medical Assistance Services. Provider Enrollment & Revalidation. Checked October 30, 2026.
52. 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.”.
53. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Appendix D: Service Authorization (revision date September 24, 2026). Checked October 30, 2026.
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    “Service Limitations Physical therapy, occupational therapy, and speech-language pathology services shall be limited to five (5) visits per rehabilitative discipline annually without service authorization. Initial therapy evaluations are included in the 5 visits. ... "Annually" is defined as July 1 through June 30. ... Srv Auth is required when more than 5 visits are medically necessary. ... Srv Auth for outpatient rehabilitation services must be obtained through Acentra Health.”
54. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Appendix D: Service Authorization (revision date September 24, 2026). “Please contact the individual’s Medicaid MCO for information on submitting service authorization requests for individuals enrolled in managed care.” Checked October 30, 2026.
55. Virginia Department of Medical Assistance Services. Provider Manuals, Chapter I: General Information (revision date October 22, 2026). Checked October 30, 2026.
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    “Coverage for the majority of Medicaid enrolled individuals is provided through the DMAS managed care program. DMAS contracts with managed care organizations (MCOs) that all offer full coverage statewide. ... Enrollment in managed care is mandatory for most members.”
56. Virginia Department of Medical Assistance Services. Cardinal Care. Checked October 30, 2026.
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    “All managed care and fee-for-service Medicaid members are part of the Cardinal Care program. ... As of July 1, 2025, Virginia Medicaid will have 5 Managed Care Plans: Aetna Better Health of Virginia: Aetna Medicaid Virginia Anthem HealthKeepers Plus: Anthem NEW Humana Healthy Horizons of Virginia: Humana Healthy Horizons Sentara Health Plans: Sentara Health Plans United Healthcare of the Mid-Atlantic, Inc: UnitedHealthcare Community Plan ... Providers must enroll with the State via PRSS and Contract with the Managed Care Plans individually.”
57. Virginia Department of Medical Assistance Services. Procedure Fee Files & CPT Codes. Checked October 30, 2026.
58. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Chapter IV: Covered Services and Limitations (revision date December 29, 2023). Checked October 30, 2026.
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    “An outpatient therapy visit is the treatment session in which a rehabilitation therapist provides the individual services prescribed by a physician or other licensed practitioner of the healing arts. Reimbursement is made on a per visit basis.”
59. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Appendix D: Service Authorization (revision date September 24, 2026). “In-state general hospital and in -state rehabilitation hospital providers (Provider Types 001,014) use DMAS approved revenue codes: ... In-state private rehabilitation agencies, CORFs, and physician providers (Provider Types 057,019,020, respectively) use DMAS approved CPT codes ...” Checked October 30, 2026.
60. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Appendix D: Service Authorization (revision date September 24, 2026). Checked October 30, 2026.
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    “97110 Therapeutic procedure, Physical Therapy, each 15 minutes. 1 unit = 15 minutes. ... 97150 Therapeutic procedure, Physical Therapy, Group. 1 unit = a group session ... 97161* Physical Therapy evaluation: low complexity 1 unit = an evaluation 97162* Physical Therapy evaluation: moderate complexity 1 unit = an evaluation 97163 Physical Therapy evaluation: high complexity 1 unit = an evaluation.”
61. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Appendix D: Service Authorization (revision date September 24, 2026). Checked October 30, 2026.
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    “97530 Therapeutic procedure, Occupational Therapy, each 15 Minutes. 1 unit = 15 minutes. S9129 Therapeutic procedure, Occupational Therapy, Group. 1 unit = a group session. 97165* Occupational Therapy evaluation: low complexity 1 unit = an evaluation 97166* Occupational Therapy evaluation: moderate complexity 1 unit = an evaluation 97167 Occupational Therapy evaluation: high complexity 1 unit = an evaluation.”
62. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Appendix D: Service Authorization (revision date September 24, 2026). Checked October 30, 2026.
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    “92507 Treatment of speech, language, voice, communication, and / or auditory processing disorder; Individual. 1 unit = one treatment session 92508 Treatment of speech, language, voice, communication, and / or auditory processing disorder; Group, 2 or more individuals. 1 unit = one treatment session. ... For non-hospital providers: Four (4) specific codes are utilized for speech therapy evaluation as follows: 92521 Evaluation of speech fluency (e.g. stuttering, cluttering)”
63. Virginia Department of Medical Assistance Services. Rehabilitation Manual, Appendix D: Service Authorization (revision date September 24, 2026). “*For CPT Codes 97110 (PT) and 97530 (OT), when requesting a Service Authorization (Srv Auth) for these 2 codes, the units of time being requested should be based on the 15-minute interval and not based on a visit.” Checked October 30, 2026.
64. Virginia Department of Medical Assistance Services. Local Education Agency Manual, Chapter IV: Covered Services and Limitations (revision date January 12, 2024). Checked October 30, 2026.
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    “School-based services are: • Covered under the federal Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit; • Provided by Local Education Agencies (LEAs) * to children enrolled in Medicaid and Family Access to Medical Insurance Security (FAMIS), Virginia’s Children’s Health Insurance Program (CHIP); ... • Billed by the LEA via DMAS’ school-based services interim claiming process; • Carved out of the DMAS managed care delivery system; and • Reimbursed on a cost basis through an annual cost reconciliation process. ... Covered services include: • Well-child visits and health-related screenings • Physical therapy (PT) • Occupational therapy (OT) • Speech-language therapy (SLP)”
65. Virginia Department of Medical Assistance Services. Telehealth Services Supplement (revision date January 5, 2026). Checked October 30, 2026.
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    “Table 1. Medicaid-covered medical services authorized for delivery by telemedicine* ... Speech Language Therapy/Audiology • 92507†, 92508†, 92521, 92522, ... Physical therapy / Occupational therapy • 97110†, 97112†, 97150† • 97530†, S9129† ... Services delivered via telemedicine or audio-only telehealth must be provided with the same standard of care as services provided in person.”
66. Virginia Department of Medical Assistance Services. Telehealth Services Supplement (revision date January 5, 2026). Checked October 30, 2026.
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    “POS 02 – used for telehealth services when the originating site is other than the member’s home • POS 10 – used for telehealth services when the originating site is the member’s home ... Distant site Providers must include: • the modifier GT on claims for services delivered via telemedicine ...”
67. Virginia Board of Physical Therapy (Department of Health Professions). Guidance Document 112-21, Guidance on Telehealth (effective December 22, 2022). Checked October 30, 2026.
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    “Section Eight: Licensure Unless otherwise provided for telehealth services delivered during declared public health emergencies to ensure continuity of care, the practice of physical therapy occurs where the client is located at the time telehealth services are provided. A practitioner must be licensed by, or under the jurisdiction of, the regulatory board of the state where the client is located.”
68. Virginia Board of Physical Therapy (Department of Health Professions). Guidance Document 112-21, Guidance on Telehealth (effective December 22, 2022). “... clients should give consent to such services and evidence documenting appropriate client informed consent for the use of telehealth services should be obtained and maintained.” Checked October 30, 2026.
69. Virginia Board of Audiology and Speech-Language Pathology (Department of Health Professions). Guidance Document 30-12, Guidance for Telepractice (effective November 9, 2023). Checked October 30, 2026.
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    “2. May a practitioner licensed in another state provide services to a client located in Virginia? To provide audiology or speech-language pathology services to a client in the Commonwealth of Virginia via telepractice, a practitioner must hold a Virginia license and comply with relevant laws and regulations governing practice. 3. Are there any regulations specific to providing audiology or speech-language pathology services via telepractice? Telepractice is considered a method of service delivery. The current, applicable regulations apply to all methods of service delivery, including telepractice. The licensee is responsible for using professional judgment to determine if the type of service can be delivered via telepractice at the same standard of care as in-person service.”
70. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 38.2-3418.16. Coverage for telemedicine services. Checked October 30, 2026.
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    “A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services shall provide coverage for the cost of such health care services provided through telemedicine services, as provided in this section. ... "Telemedicine services" does not include an audio-only telephone, electronic mail message, facsimile transmission, or online questionnaire. ... C. An insurer, corporation, or health maintenance organization shall not exclude a service for coverage solely because the service is provided through telemedicine services and is not provided through face-to-face consultation or contact between a health care provider and a patient for services appropriately provided through telemedicine services. ... such insurer, corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services on the same basis that the insurer, corporation, or health maintenance organization is responsible for coverage for the provision of the same service through face-to-face consultation or contact.”
71. Virginia Department of Taxation (Virginia Tax). Register a Business in Virginia. Checked October 30, 2026.
72. Virginia Department of Taxation (Virginia Tax). Retail Sales and Use Tax. “What is it? A tax on the sale, lease, and rental of: tangible personal property in or for use in Virginia, accommodations certain taxable services unless an exemption or exception is established.” Checked October 30, 2026.
73. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 58.1-609.5. Service exemptions. Checked October 30, 2026.
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    “The tax imposed by this chapter or pursuant to the authority granted in § 58.1-605 or 58.1-606 shall not apply to the following: 1. Professional, insurance, or personal service transactions which involve sales as inconsequential elements for which no separate charges are made ...”
74. Virginia Workers’ Compensation Commission. Employer FAQs. Checked October 30, 2026.
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    “1. Am I required to obtain workers’ compensation insurance? Virginia law requires that an employer who regularly employs more than two part-time or full-time employees carry workers’ compensation. If a business hires subcontractors to perform the same trade, business or occupation, or to fulfill a contract, the subcontractor’s employees are included when determining the total number of employees for coverage requirements. Executive officers also count as employees. If the total number of all employees is more than two, workers’ compensation is required.”
75. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 65.2-800. Duty to insure payment of compensation; effect of insurance. “A. Every employer subject to the compensation provisions of this title shall insure the payment of compensation to his employees in the manner hereinafter provided.” Checked October 30, 2026.
76. 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.”.
77. 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.”.
78. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 32.1-127.1:03. Health records privacy. Checked October 30, 2026.
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    “A. There is hereby recognized an individual’s right of privacy in the content of his health records. Health records are the property of the health care entity maintaining them, and, except when permitted or required by this section or by other provisions of state law, no health care entity, or other person working in a health care setting, may disclose an individual’s health records.”
79. Virginia General Assembly, Legislative Information System (Virginia Administrative Code). 18VAC112-20-160. Requirements for patient records.. “A. Practitioners shall comply with provisions of § 32.1-127.1:03 of the Code of Virginia related to the confidentiality and disclosure of patient records.” Checked October 30, 2026.
80. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 18.2-186.6. Breach of personal information notification. Checked October 30, 2026.
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    “B. If unencrypted or unredacted personal information was or is reasonably believed to have been accessed and acquired by an unauthorized person and causes, or the individual or entity reasonably believes has caused or will cause, identity theft or another fraud to any resident of the Commonwealth, an individual or entity that owns or licenses computerized data that includes personal information shall disclose any breach of the security of the system following discovery or notification of the breach of the security of the system to the Office of the Attorney General and any affected resident of the Commonwealth without unreasonable delay.”
81. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 63.2-1606. Protection of aged or incapacitated adults; mandated and voluntary reporting. Checked October 30, 2026.
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    “Reports shall be made to the local department or the adult protective services hotline in accordance with requirements of this section by the following persons acting in their professional capacity: 1. Any person licensed, certified, or registered by health regulatory boards listed in § 54.1-2503, with the exception of persons licensed by the Board of Veterinary Medicine ...”
82. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 54.1-2503. Boards within Department. Checked October 30, 2026.
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    “The following boards are included within the Department: Board of Audiology and Speech-Language Pathology, Board of Counseling, Board of Dentistry, Board of Funeral Directors and Embalmers, Board of Long-Term Care Administrators, Board of Medicine, Board of Nursing, Board of Optometry, Board of Pharmacy, Board of Physical Therapy ...”
83. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 63.2-1509. (Effective until July 1, 2027) Requirement that certain injuries to children be reported by physicians, nurses, teachers, etc.; penalty for failure to report. Checked October 30, 2026.
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    “A. The following persons who, in their professional or official capacity, have reason to suspect that a child is an abused or neglected child, shall report the matter immediately to the local department of the county or city wherein the child resides or wherein the abuse or neglect is believed to have occurred or to the Department’s toll-free child abuse and neglect hotline: 1. Any person licensed to practice medicine or any of the healing arts; 2. Any hospital resident or intern, and any person employed in the nursing profession ...”
84. Virginia General Assembly, Legislative Information System (Code of Virginia). Code of Virginia § 38.2-3418.17. Coverage for autism spectrum disorder. Checked October 30, 2026.
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    “... each health maintenance organization providing a health care plan for health care services shall, as provided in this section, provide coverage for the diagnosis of autism spectrum disorder and the treatment of autism spectrum disorder, in individuals (i) from January 1, 2012, until January 1, 2016, from age two years through age six years; (ii) from January 1, 2016, until January 1, 2020, from age two years through age 10 years; and (iii) from and after January 1, 2020, of any age, subject to the annual maximum benefit limitation set forth in subsection K ... "Therapeutic care" means services provided by licensed or certified speech therapists, occupational therapists, physical therapists, or clinical social workers. ... K. Coverage for applied behavior analysis under this section will be subject to an annual maximum benefit of $35,000, unless the insurer, corporation, or health maintenance organization elects to provide coverage in a greater amount.”
85. Virginia Department of Health, Office of Family Health. Care Connection for Children. Checked October 30, 2026.
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    “Care Connection for Children is a statewide network of centers of excellence for children and youth with special health care needs (CYSHCN) that provide leadership in the enhancement of specialty medical services; care coordination; medical insurance benefits evaluation and coordination; management of the CYSHCN Pool of Funds; ... Eligibility Birth to 21 years of age Virginia Resident ... The funds assist with payment of certain services such as medications, diagnostic testing, therapies, durable medical equipment, and hospitalizations. A limited amount of money is available to assist those who are: Uninsured or underinsured Whose families have gross family income at or below 300% of the Federal Poverty Level Preauthorization is required for the use of CSHCN Pool of Funds ...”
86. Centers for Medicare & Medicaid Services. Medicare Administrative Contractors (MACs). Checked October 30, 2026.
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    “L Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania (includes Part B for counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia) Novitas Solutions, Inc. M North Carolina, South Carolina, Virginia, West Virginia (excludes Part B for the counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia) **HH + H for the following states: Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, and Texas Palmetto GBA, LLC ...”
87. Palmetto GBA (Medicare Administrative Contractor). Palmetto GBA - Jurisdiction M Part B. “Jurisdiction M Part B MAC ... Part B Providers in North and South Carolina, Virginia and West Virginia ...” Checked October 30, 2026.
88. Virginia Workers’ Compensation Commission. 2026 Medical Fee Schedules Ground Rules. Checked October 30, 2026.
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    “Physical Medicine and Rehabilitation Services The CPT and HCPCS codes listed in Table Z represent physical medicine and rehabilitation services subject to the 2026 MFS, and the maximum fee shall be established as a fixed amount per unit. ... The maximum fees apply when the services are provided in a setting other than a hospital. If the services are provided in a hospital setting, the maximum fee from the Hospital Outpatient Facility MFS applies.”
89. Virginia Workers’ Compensation Commission. 2026 Medical Fee Schedules Ground Rules. “Non-physician practitioners (NPPs) include professionals such as a nurse practitioner, physician assistant, clinical nurse specialist, clinical psychologist, clinical social worker, physical therapist, occupational therapist, or speech therapist. NPPs shall be reimbursed according to the rules outlined in the Maximum Fee Reimbursement section.” Checked October 30, 2026.
90. the Virginia Physical Therapy Association (VPTA). the Virginia Physical Therapy Association (VPTA) (the state association's site). Checked October 30, 2026.
91. the Virginia Occupational Therapy Association (VOTA). the Virginia Occupational Therapy Association (VOTA) (the state association's site). Checked October 30, 2026.
92. the Speech-Language-Hearing Association of Virginia (SHAV). the Speech-Language-Hearing Association of Virginia (SHAV) (the state association's site). Checked October 30, 2026.
93. DrSensory. Occupational therapy clinics in Virginia, 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.
94. 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 Virginia, not legal, compliance, billing or financial advice. Rules change; the clinic confirms each with its source before acting on it.