For therapists

Washington PT, OT and SLP guide

Who licenses OTs, PTs and SLPs in Washington, whether patients need a referral, how Apple Health pays for children and adults, telehealth and the compacts, the business and records rules, and a launch checklist, every rule quoted from its source.

  • Sources Cited
  • Worksheet Included
  • For Clinicians

Written by the DrSensory Editorial Team · How we write and who reviews it · Last updated October 30, 2026
Last verified against official sources on October 30, 2026

For OT, PT and SLP clinics in Washington: three state boards license the disciplines, a physical therapist may treat neuromuscular or musculoskeletal conditions with no consultation or periodic review by an authorized health care practitioner required, Apple Health covers children’s therapy under EPSDT and adults within its own rules, and telehealth follows the patient’s location.⁠1,2,3

Key takeaways

  • In Washington, physical therapists are licensed by the Washington Board of Physical Therapy, occupational therapists by the Washington Occupational Therapy Practice Board and speech-language pathologists by the Washington Board of Hearing and Speech, each under its own licensing law and rules.⁠1,4,5
  • For physical therapy, a physical therapist may treat neuromuscular or musculoskeletal conditions with no consultation or periodic review by an authorized health care practitioner required, performs wound care only by referral from or after consultation with an authorized health care practitioner, and refers a patient on when symptoms or conditions call for services beyond physical therapy or physical therapy is contraindicated; Apple Health, as a payer, pays for outpatient rehabilitation only when it is ordered by a physician, physician assistant or advanced registered nurse practitioner and begun within 30 days of the order.⁠2,6,7,8
  • Apple Health covers occupational, physical and speech therapy for children under EPSDT, and its adult coverage follows the limits in its provider manual.⁠3,9
  • Telehealth to a patient in Washington requires authority to practice where the patient is located; the PT Compact, the OT Compact and the ASLP Interstate Compact stand as their commissions state for Washington.⁠10,11,12,13,14,15,16,17
  • Medicare’s plan of care must be certified by a physician or nonphysician practitioner, and since January 2025 a signed order or referral on file can stand in for that signature on an initial plan delivered within 30 days of the evaluation.⁠18
  • Apple Health requires its providers to keep legible, accurate and complete records and to make them available to the agency and the federal Department of Health and Human Services for six years from the date of service, or longer where federal or state law requires. The physical therapy rule requires each record to include the date of treatment, the treatment record and the signature of the person responsible.⁠19,20
  • The business entity is registered with the Corporations and Charities Division of the Office of the Secretary of State, and the state’s rules on who may own a therapy entity apply.⁠21,22,23
  • A child under three with a developmental delay is referred to Early Support for Infants and Toddlers (ESIT), which runs separately from an outpatient clinic’s own intake.⁠24,25

Who licenses OTs, PTs and SLPs in Washington?

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

DisciplineBoardLicensing law and rulesRenewal and continuing educationAssistants
Physical therapyWashington Board of Physical TherapyChapter 18.74 RCW (Physical Therapy); Chapter 246-915 WAC (Physical Therapists and Physical Therapist Assistants)Every year, on the practitioner’s birthday, for physical therapists and physical therapist assistants alike; 32 hours of continuing education every two years for physical therapists and 24 for physical therapist assistants, each including 2 hours of health equity training, plus 200 hours applying physical therapy knowledge and skills in the same two yearsOnly the physical therapist interprets referrals, examines, diagnoses and sets the plan of care; a PTA works under direct or indirect supervision, the physical therapist reevaluates the patient at the later of every fifth visit or every thirty days when the PTA has given the care, and one physical therapist supervises at most three assistive personnel at a time⁠1,26,27,28,29
Occupational therapyWashington Occupational Therapy Practice BoardChapter 18.59 RCW (Occupational Therapy); Chapter 246-847 WAC (Occupational Therapists and Occupational Therapy Assistants)Every two years, on the practitioner’s birthday; 24 hours of continuing education or continuing competency every two years, at least 20 of them directly related to occupational therapy, including at least 2 hours of health equity training every four yearsA licensed occupational therapy assistant works in documented regular consultation with a Washington-licensed occupational therapist, meaning at least monthly contact with further supervision available as needed⁠4,30,31,32,33,34
Speech-language pathologyWashington Board of Hearing and SpeechChapter 18.35 RCW (Hearing and Speech Services); Chapter 246-828 WAC (Hearing and Speech)Every year, on the practitioner’s birthday; 30 hours of continuing education every three years: one hour from passing the jurisprudence examination, at least one hour on infection control, at least 2 hours of health equity training and at least 25 hours on profession-specific skillsA certified speech-language pathology assistant performs only tasks the speech-language pathologist delegates, some under direct supervision and others, such as carrying out treatment plans, IEPs and IFSPs, under direct or indirect supervision; diagnosis, evaluation, swallowing screening and writing or changing treatment plans stay with the speech-language pathologist⁠5,35,36,37

Physical therapists and physical therapist assistants answer to the Washington Board of Physical Therapy.⁠1,26,27,28,29 Occupational therapists and occupational therapy assistants answer to the Washington Occupational Therapy Practice Board.⁠4,30,31,32,33,34 Speech-language pathologists answer to the Washington Board of Hearing and Speech.⁠5,35,36,37 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 Washington license renewal require?

Each board sets its own cycle and hours, listed in the table above, and the register template at the end of this page tracks them per clinician.⁠1,4,5 A renewal missed is a lapse, and the board’s own rules say what a lapsed licensee may and may not do; the clinic reads those rules before a clinician’s renewal date passes, not after.

Can a patient see a Washington PT, OT or SLP without a referral?

State law answers this discipline by discipline, and a payer may still require a referral the law does not. For physical therapy, a physical therapist may treat neuromuscular or musculoskeletal conditions with no consultation or periodic review by an authorized health care practitioner required, performs wound care only by referral from or after consultation with an authorized health care practitioner, and refers a patient on when symptoms or conditions call for services beyond physical therapy or physical therapy is contraindicated.⁠2,6,7,8 For occupational therapy, an occupational therapist who finds after evaluating a patient that the case is a medical one refers it to a physician for medical direction if that direction is lacking, and treats such a medical case only on the referral of a physician, osteopathic physician, podiatric physician and surgeon, naturopath, chiropractor, physician assistant, psychologist, optometrist or advanced registered nurse practitioner.⁠38,39 For speech-language pathology, the board’s rule calls licensed speech-language pathologists independent practitioners who identify, assess and treat communication disorders and dysphagia in people of all ages, with referral to other qualified resources when appropriate.⁠40,41 Apple Health, as a payer, pays for outpatient rehabilitation only when it is ordered by a physician, physician assistant or advanced registered nurse practitioner and begun within 30 days of the order.⁠8

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.⁠18 Apple Health’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 Apple Health pay for pediatric and adult therapy?

Apple Health is Washington’s Medicaid program, run by the Washington State Health Care Authority (HCA), and a clinic enrolls through its provider enrollment route before it bills.⁠42 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.⁠43 For clients age 20 and younger, Apple Health covers unlimited outpatient occupational, physical and speech therapy, except for clients 19 and 20 receiving Medical Care Services (MCS), and EPSDT includes every medically necessary service for that age group.⁠3

For clients 21 and older, Apple Health covers outpatient rehabilitation as a short-term benefit for an acute condition, a new injury or recovery from surgery, limited each calendar year to 24 units (about 6 hours) of physical therapy, 24 units of occupational therapy for physical conditions and 6 untimed speech therapy visits.⁠9 Units beyond an adult’s yearly limit go through expedited prior authorization, usable once per client each calendar year for each therapy, or else a limitation extension request on form HCA 13-786 with its documentation.⁠44 Most Apple Health clients are enrolled in one of HCA’s contracted managed care organizations, and a clinic sends those clients’ claims to the client’s plan and calls the plan about payment before providing the service.⁠45 The fee schedule is published by the agency, and a clinic reads the current file rather than a remembered rate.⁠46

How does Apple Health want OT, PT and SLP claims coded?

Apple Health therapy claims carry the discipline’s modifier, GP for physical therapy, GO for occupational therapy and GN for speech therapy, with CQ or CO added beside GP or GO for services by a physical therapist assistant or occupational therapy assistant, and every claim lists the referring provider’s NPI.⁠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 Apple Health pay for therapy in schools?

School-based health care services (SBHS), an optional fee-for-service Apple Health program outside managed care, reimburses contracted school districts, educational service districts, charter schools and Tribal schools for covered services in a student’s 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 Apple Health cover therapy by telehealth?

Apple Health pays for some physical, occupational and speech therapy evaluations, re-evaluations and treatments by audio-visual telemedicine. Audio-only telemedicine is allowed for speech services after an in-person initial evaluation and for fewer than half of the year’s visits, and not for outpatient physical or occupational therapy.⁠50 The telehealth section below covers the state’s own rules for the session itself.

What are Washington’s telehealth rules for therapy?

A therapist treating a patient by video needs authority to practice where the patient is located at the time of the session, and the federal telehealth site says so plainly: licensure follows the patient’s location, and a compact privilege is one route to it.⁠10 Washington’s Uniform Telehealth Act holds telehealth to a patient located in Washington to the professional practice standards of comparable in-person care, including documentation, informed consent, confidentiality, privacy and security, and an out-of-state practitioner treats a Washington patient by telehealth under a Washington license or another authorization such as a compact Washington belongs to.⁠51,52,53,54

CompactWashington’s statusSource
PT Compact (physical therapy)Member state: the commission lists Washington among the 38 member states actively issuing and accepting compact privileges (October 30, 2026); the Department of Health says Washington joined the compact on April 25, 2017 and that privileges for Washington became available in September 2019The PT Compact Commission and the Washington State Department of Health⁠11,12
OT Compact (occupational therapy)Member with an appointed state commissioner (appointed April 22, 2022); the commission’s application table lists Washington as "Not Yet" accepting OT Compact privilege applications (page dated October 26, 2026)The OT Compact Commission⁠13,14
ASLP Interstate Compact (speech-language pathology and audiology)Member with two appointed delegates on the commission’s roster (an audiologist and a speech-language pathologist); the commission says registration for compact privileges is open only for practitioners licensed in Louisiana, Ohio, Tennessee and West Virginia, so Washington is not yet issuing privileges (October 30, 2026)The ASLP-IC Commission and the Washington State Department of Health⁠15,16,17

A compact privilege is not a national license: it is a privilege to practice in the specific member state that issued it, under that state’s licensing law, and a state that has enacted the compact may not yet be issuing privileges, which is why the table names the commission’s current status.⁠11,12 RCW 48.43.735 requires a health carrier to reimburse a medically necessary service delivered by telemedicine when the plan covers it in person and, for plans issued or renewed on or after January 1, 2021, to pay the same amount as in person, though hospitals, hospital systems, telemedicine companies and provider groups of eleven or more providers may negotiate a different amount.⁠55

Which business steps are specific to Washington?

The entity is registered with the Corporations and Charities Division of the Office of the Secretary of State, and the choice of entity is shaped by the state’s rule on who may own a therapy business.⁠21 Washington lets health care professionals licensed under listed chapters, among them chapter 18.74 RCW (physical therapy), chapter 18.59 RCW (occupational therapy) and chapter 18.35 RCW (hearing and speech), own stock in and practice through one professional service corporation, and a professional limited liability company is subject to the provisions of chapter 18.100 RCW that apply to a professional corporation.⁠22,23 State tax registration is with the Department of Revenue, which issues the state business license and the Unified Business Identifier (UBI) number.⁠56 A health care provider licensed under Title 18 RCW pays the service and other activities B&O tax on its income from health care services. An item sold as a convenience apart from those services is a retail sale, on which the provider pays retailing B&O tax and collects retail sales tax unless the sale is specifically exempt.⁠57,58 Washington does not allow private workers’ compensation coverage: an employer buys coverage from the Department of Labor & Industries’ state fund or qualifies as a self-insurer, and sole proprietors and partners are among the few employments outside mandatory coverage.⁠59,60,61 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 Washington?

Apple Health requires its providers to keep legible, accurate and complete records and to make them available to the agency and the federal Department of Health and Human Services for six years from the date of service, or longer where federal or state law requires. The physical therapy rule requires each record to include the date of treatment, the treatment record and the signature of the person responsible.⁠19,20 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.⁠62,63

Washington’s Uniform Health Care Information Act (RCW 70.02.020) bars a health care provider, its staff and its agents from disclosing a patient’s health care information without the patient’s written authorization, except as the chapter itself allows. Washington’s My Health My Data Act (chapter 19.373 RCW) applies to any legal entity doing business in Washington that decides how consumer health data is collected, processed or shared, and does not apply to protected health information under HIPAA or to health care information handled under chapter 70.02 RCW.⁠64,65 RCW 19.255.010 requires a business that owns or licenses personal information to notify each Washington resident whose unsecured personal information was, or is reasonably believed to have been, acquired by an unauthorized person, no more than thirty calendar days after discovering the breach, and to notify the attorney general within thirty days when more than five hundred Washington residents are notified.⁠66 RCW 26.44.030 requires a practitioner with reasonable cause to believe a child has suffered abuse or neglect to report it to law enforcement or the Department of Children, Youth, and Families at the first opportunity and within 48 hours, and RCW 26.44.020 defines a practitioner to include a person licensed by the state to provide health services.⁠67,68

Which Washington rules shape a pediatric clinic?

Early Support for Infants and Toddlers (ESIT), the Department of Children, Youth, and Families’ program under Part C of IDEA, serves children from birth to age 3 with developmental delays or disabilities and their families. DCYF lists an Early Intervention Referral Form for Healthcare Providers, and families call the Help Me Grow hotline (1-800-322-2588), which can tell them whether a child is eligible.⁠24,25 A child who turns three moves from early intervention to the school district’s evaluation, and a private clinic’s services run beside both systems rather than inside them. Washington requires employer-sponsored group health insurance, health care service contractor and HMO plans to cover neurodevelopmental therapies, meaning occupational, speech and physical therapy, for covered individuals age six and under, and lets those plans set annual or lifetime benefit limits.⁠69,70,71

Which Washington rules shape an adult clinic?

Medicare claims from Washington go to Noridian Healthcare Solutions, LLC, the Medicare Administrative Contractor for Jurisdiction F, Parts A and B (Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming), whose local coverage articles for therapy are the ones a Washington clinic reads.⁠72 Apple Health’s adult therapy rules are in the Medicaid section above. The Department of Labor & Industries publishes the payment policies and maximum fees for treating injured workers, the 2026 set effective July 1, 2026. Physical medicine billed under CPT 97010-97799 needs a referral from the worker’s attending provider, the first 12 visits need no authorization on an open, allowed claim for an accepted condition, and visits 13 to 24 need the insurer’s prior authorization.⁠73,74

Which associations and directory pages serve Washington?

The state chapters are APTA Washington for physical therapy, the Washington Occupational Therapy Association for occupational therapy and the Washington Speech-Language Hearing Association for speech-language pathology.⁠75,76,77 On DrSensory, families browse Washington clinics by discipline on the occupational therapy, physical therapy and speech therapy pages for the state, which the directory builds from the clinic addresses it holds; a clinic appears on the pages of its own address.⁠78

Which Washington cities have DrSensory city pages?

Beyond its three Washington pages, the directory publishes city pages for 4 Washington cities, 12 pages across the three disciplines, each listing the clinics whose address is in that city; a clinic appears on the city page of its address without any action of its own, and a city or discipline without a page is reached through the state page.⁠78

CityOccupational therapyPhysical therapySpeech therapy
SeattleOccupational therapy in SeattlePhysical therapy in SeattleSpeech therapy in Seattle
SpokaneOccupational therapy in SpokanePhysical therapy in SpokaneSpeech therapy in Spokane
TacomaOccupational therapy in TacomaPhysical therapy in TacomaSpeech therapy in Tacoma
VancouverOccupational therapy in VancouverPhysical therapy in VancouverSpeech therapy in Vancouver

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

DrSensory lists 126 PT, OT and SLP clinics in Washington, on its occupational therapy, physical therapy and speech therapy pages for the state.⁠78

Is your clinic one of the 126?

An unclaimed listing shows what public records hold: the name, address, phone and therapy. A claimed listing carries the Claimed and verified badge and the clinic’s own name, address, phone, hours, website, therapies, ages served and insurance accepted, corrected in the clinic’s own editor.

Claiming starts with finding the listing and confirming the clinic’s email with a six-digit code. Claiming is free. Nothing is charged. The subscription, the one paid tier, adds a description, photos, clinicians, reviews and family messages, at $349.99 a year or $29.99 a month for the first location.

Claim your listingSee the pricing

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

RequirementWhere it comes fromWhat the clinic doesSource
A license for each clinicianWashington Board of Physical Therapy, Washington Occupational Therapy Practice Board, Washington Board of Hearing and SpeechVerify every license on the board’s site and enter its renewal date in the register1,4,5,26,27,28,29,30,31,32,33,34,35,36,37
Referral or direct accessThe licensing law for each disciplineSet the intake rule per discipline; keep the payer’s rule beside it2,6,7,8,38,39,40,41
Medicaid enrollment and coverageThe Washington State Health Care Authority (HCA)Enroll, read the provider manual’s therapy sections, note who issues authorizations3,42
Medicare plan of care42 CFR 424.24Certify every plan, or hold the signed order or referral on file with the plan delivered within 30 days18
Telehealth across a state lineThe patient’s state and the compactsConfirm the patient’s location each session; hold a license or a privilege there10,11,12
The business entityThe Corporations and Charities Division of the Office of the Secretary of StateChoose the entity the state’s law allows and register it21,22,23
Record retentionState law, Medicare and HIPAAKeep the longest period that applies19,20,62

Which templates does a Washington launch need?

Washington launch checklist. Each line names its source so the clinic can re-read the rule when it changes.

  • Physical therapy licenses verified with the Washington Board of Physical Therapy; renewal dates and continuing-education hours entered in the register
  • Occupational therapy licenses verified with the Washington Occupational Therapy Practice Board; the same
  • Speech-language pathology licenses verified with the Washington Board of Hearing and Speech; the same
  • The intake rule for referrals set per discipline from the licensing law, with the payer’s rule beside it
  • Apple Health enrollment filed; the provider manual’s therapy sections and who issues authorizations noted
  • Medicare enrollment and the plan-of-care routine in place
  • Telehealth: the patient-location check at every session; licenses or compact privileges for every state served
  • The entity registered with the Corporations and Charities Division of the Office of the Secretary of State; the ownership rule read
  • The state’s sales-tax rule on services and on goods sold to patients read; a seller’s permit where the clinic sells goods
  • Record retention set to the longest period that applies
  • The early-intervention and school pathways known to intake, with the referral routes
  • The Medicare contractor’s therapy articles bookmarked
  • The state association memberships decided

License and renewal register. One line per clinician.

  • Clinician: [their name]
  • Discipline and board: [physical therapy, occupational therapy or speech-language pathology; the board]
  • License number: [as the board lists it]
  • Renewal date: [the date]
  • Continuing-education hours due and completed: [hours due by the board’s rule; hours completed to date]
  • Compact privileges held: [the states and the privilege numbers, if any]
  • Checked on the board’s site: [the date and by whom]

Payer register. One line per payer the clinic bills.

  • Payer: [Apple Health, a managed care plan, Medicare through Noridian Healthcare Solutions, LLC, a commercial plan]
  • Enrollment or contract status and effective date: [the status; the date]
  • Referral rule: [what the payer requires]
  • Authorization rule and who issues it: [what needs authorization; who issues it]
  • Telehealth rule: [covered services and modifiers]
  • Fee schedule location and date read: [where; when]
  • Owner: [who keeps this line current]

How might two Washington clinics plan a launch?

A pediatric occupational therapy clinic in Seattle. Hypothetical; a planning exercise, not a claim about demand in Seattle.

  • Licensing: the owner and one occupational therapy assistant are verified with the Washington Occupational Therapy Practice Board; the assistant’s supervision rule from the board goes into the staffing plan.
  • Referrals: the licensing law’s rule for occupational therapy sets the intake script; Apple Health’s referral and authorization rules sit beside it, since most of the first families are enrolled through a managed care plan.
  • Medicaid: enrollment is filed before the first family is scheduled, and the program’s authorization rule for children, quoted above, is written into the scheduling routine.
  • Early intervention: families with children under three are told how the referral to Early Support for Infants and Toddlers (ESIT) works and that the clinic’s services run beside it.
  • Records: the chart policy is set on day one at or above the longest retention period that applies.

An adult physical therapy clinic in Spokane. Hypothetical; a planning exercise, not a claim about demand in Spokane.

  • Licensing: two physical therapists verified with the Washington Board of Physical Therapy; one holds a PT Compact privilege for a neighboring state, which the telehealth policy records.
  • Referrals: the licensing law’s direct-access rule sets the intake script; Medicare’s plan-of-care routine is written before the first Medicare patient, with the signed order or referral held on file where the referring practitioner sends one.
  • Medicare: enrollment through Noridian Healthcare Solutions, LLC; the contractor’s therapy articles are read for the codes the clinic bills.
  • Telehealth: the patient-location check is part of every video session’s note; a patient who travels out of state is seen only where the clinic holds authority.
  • Business: the entity is registered with the Corporations and Charities Division of the Office of the Secretary of State in the form the state’s law allows, and the local business license is filed with the city.

Frequently asked questions

Can I practice in Washington on a compact privilege from another state?

Only as the compact’s commission states for Washington: the table above gives each compact’s status, and a privilege is issued for a specific member state under that state’s licensing law, not as a national license.⁠11,12,13,14,15,16,17

Does Apple Health cover therapy for adults?

Within its own rules: the provider manual sets what is covered for adults, with the limits and authorization requirements quoted in the Medicaid section, while children’s coverage runs under EPSDT.⁠9,43

Do patients in Washington need a referral before therapy?

The licensing law answers per discipline and the referral section quotes each rule; a payer may still require a referral or a certified plan of care the law does not, so the intake script carries both rules.⁠2,6,7,8,18

Can I treat a Washington patient by telehealth from another state?

Only with authority to practice in Washington, since licensure follows the patient’s location; a compact privilege is one route where the compact is live for the state.⁠10,11,12

How long must a Washington clinic keep therapy records?

Apple Health requires its providers to keep legible, accurate and complete records and to make them available to the agency and the federal Department of Health and Human Services for six years from the date of service, or longer where federal or state law requires. The physical therapy rule requires each record to include the date of treatment, the treatment record and the signature of the person responsible.⁠19,20 Medicare’s 7-year and HIPAA’s 6-year rules cover other documents and do not shorten it.⁠62,63

Which entity can a Washington therapy clinic form?

Washington lets health care professionals licensed under listed chapters, among them chapter 18.74 RCW (physical therapy), chapter 18.59 RCW (occupational therapy) and chapter 18.35 RCW (hearing and speech), own stock in and practice through one professional service corporation, and a professional limited liability company is subject to the provisions of chapter 18.100 RCW that apply to a professional corporation.⁠22,23 Registration with the Corporations and Charities Division of the Office of the Secretary of State follows the choice.⁠21

How is a young child referred to early intervention in Washington?

Through Early Support for Infants and Toddlers (ESIT), DCYF’s Part C program for children from birth to age 3; providers use DCYF’s Early Intervention Referral Form, and families call the Help Me Grow Washington hotline at 1-800-322-2588.⁠24,25

Where do families find Washington therapy clinics on DrSensory?

On the state’s occupational therapy, physical therapy and speech therapy pages and on the city pages listed above, built from the clinic addresses the directory holds; a clinic’s listing appears on the pages of its own address, and a paid listing adds the clinic’s own description, hours and specialties.⁠78,79

More for therapists

Sources

  1. Washington State Department of Health. Washington Board of Physical Therapy. Checked October 30, 2026.
  2. Washington State Legislature (Office of the Code Reviser). RCW 18.74.012: Consultation with health care practitioner not required for certain treatments. “A consultation and periodic review by an authorized health care practitioner is not required for treatment of neuromuscular or musculoskeletal conditions.” Checked October 30, 2026.
  3. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). Checked October 30, 2026.
    Show the passageHide the passage
    “For eligible clients age 20 years and younger, the Health Care Authority covers unlimited outpatient rehabilitation, with the exception of clients age 19 through 20 receiving Medical Care Services (MCS). ... Early periodic screening, diagnosis, and treatment (EPSDT) includes all services that are medically necessary to address health conditions for clients age 20 and younger.”
  4. Washington State Department of Health. Washington Occupational Therapy Practice Board. Checked October 30, 2026.
  5. Washington State Department of Health. Washington Board of Hearing and Speech. Checked October 30, 2026.
  6. Washington State Legislature (Office of the Code Reviser). RCW 18.74.010: Definitions. “A physical therapist may perform wound care services only by referral from or after consultation with an authorized health care practitioner ...” Checked October 30, 2026.
  7. Washington State Legislature (Office of the Code Reviser). RCW 18.74.015: Referral to health care practitioners - When required. Checked October 30, 2026.
    Show the passageHide the passage
    “(1) Physical therapists shall refer persons under their care to authorized health care practitioners if they have reasonable cause to believe symptoms or conditions are present which require services beyond the scope of their practice or for which physical therapy is contraindicated.”
  8. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). “HCA pays for outpatient rehabilitation as described in WAC 182-545-200 when the services are: ... Ordered by a physician, physician assistant (PA), or an advanced registered nurse practitioner (ARNP). ... Begun within 30 days of the date ordered.” Checked October 30, 2026.
  9. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). Checked October 30, 2026.
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    “The Health Care Authority covers outpatient rehabilitation for the following clients as a short-term benefit to treat an acute medical condition, disease, or deficit resulting from a new injury or post-surgery: • Clients age 19 through 20 receiving MCS • All clients age 21 and older ... These benefit limits are per client, per calendar year regardless of setting. Benefit Limits Occupational therapy • 24 units (equals approximately 6 hours) to treat physical conditions • 24 units (equals approximately 6 hours) to treat behavioral health conditions Physical therapy 24 units (equals approximately 6 hours) Speech therapy 6 units (equals a total of 6 untimed visits)”
  10. U.S. Department of Health and Human Services. Getting started with licensure (Telehealth.HHS.gov, last updated February 21, 2024). Checked October 26, 2026.
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    “Health professionals must meet the licensure requirements of the state where they are located and be licensed or legally permitted to practice in the state where the patient is located”. Its companion page, Licensing across state lines (last updated April 30, 2025): “The ability to deliver health care services across state lines varies based on state regulations”; “Prior to an appointment, providers should verify patient location and obtain consent”; “Compacts allow participating health care providers to practice in participating states”.
  11. PT Compact Commission. PT Compact Map. “Member States (38) ... Washington ... Compact Privilege Availability 38 Member States Actively Issuing and Accepting Compact Privileges ...” Checked October 30, 2026.
  12. Washington State Department of Health. Physical Therapist and Physical Therapist Assistant - Licensure Compact. “Washington State joined the Physical Therapy Compact (PTC) on April 25, 2017, making Washington the 10th state to enact the PTC. Privileges for Washington became available in September 2019.” Checked October 30, 2026.
  13. Occupational Therapy Compact Commission. Before You Apply for an OT Compact Privilege. “Accepting OT Applications? ... Washington Not Yet ...” Checked October 30, 2026.
  14. Occupational Therapy Compact Commission. State Commissioners. “State Appointed Commissioner Appointment Date ... Washington Kathy Weed Apr. 22, 2022 ...” Checked October 30, 2026.
  15. Audiology and Speech-Language Pathology Interstate Compact Commission. Delegate Information. “Member State Appointed Delegates ... Washington ... Audiology ... Nichole Kingham ... Washington ... SLP ... Sonja Bradford ...” Checked October 30, 2026.
  16. 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.
  17. Washington State Department of Health. Audiologist Speech-Language Pathologist Interstate Compact (ASLP-IC). “Washington state joined the Audiologist Speech-Language Pathologist Interstate Compact (ASLP-IC) on 07/23/2023.” Checked October 30, 2026.
  18. 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.”.
  19. Washington State Legislature (Office of the Code Reviser). WAC 182-502-0020: Health care record requirements. Checked October 30, 2026.
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    “Providers must: ... (2) Keep legible, accurate, and complete charts and records; ... (5) Make charts and records available to the medicaid agency, its contractors or designees, and the United States Department of Health and Human Services (DHHS) upon request, for six years from the date of service or longer if required specifically by federal or state law or regulation.”
  20. Washington State Legislature (Office of the Code Reviser). WAC 246-915-200: Physical therapy records. “Records must be maintained and include date of treatment, treatment record, and signature of person responsible for the treatment.” Checked October 30, 2026.
  21. Washington Secretary of State. Corporations & Charities. Checked October 30, 2026.
  22. Washington State Legislature (Office of the Code Reviser). RCW 18.100.050: Organization of professional service corporations authorized generally. Checked October 30, 2026.
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    “(5)(a) Notwithstanding any other provision of this chapter, health care professionals who are licensed or certified pursuant to chapters 18.06 , 18.225, 18.22, 18.25, 18.29, 18.34, 18.35, 18.36A, 18.50, 18.53, 18.55, 18.57, 18.59, 18.64, 18.71, 18.71A, 18.74, 18.79, 18.83, 18.89, 18.108, and 18.138 RCW may own stock in and render their individual professional services through one professional service corporation ...”
  23. Washington State Legislature (Office of the Code Reviser). RCW 25.15.046: Professional limited liability companies. Checked October 30, 2026.
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    “(1) A person or group of persons duly licensed or otherwise legally authorized to render the same professional services within this state may form and become a member or members of a professional limited liability company under the provisions of this chapter for the purposes of rendering professional service. (2) A professional limited liability company is subject to all the provisions of chapter 18.100 RCW that apply to a professional corporation.”
  24. Washington State Department of Children, Youth, and Families. Early Support for Infants & Toddlers. Checked October 30, 2026.
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    “The Early Support for Infants and Toddlers (ESIT) program gives early help to children from birth to age 3 who have developmental delays or disabilities, as well as their families. ... Individuals with Disabilities Education Act (IDEA), Part C The federal program that funds and guides ESIT’s statewide system of services and supports. ... call the Help Me Grow hotline to speak with a Family Resource Navigator at 1-800-322-2588. ... Information for Healthcare Providers Early Intervention Referral Form for Healthcare Providers ...”
  25. Washington State Department of Children, Youth, and Families. Early Intervention Eligibility. “The Help Me Grow Washington Hotline can help you find out if your child is eligible for ESS. Call 1.800.322.2588 (TTY 1.800.833.6384) for a Family Resources Coordinator in your area.” Checked October 30, 2026.
  26. Washington State Legislature (Office of the Code Reviser). WAC 246-915-990: Physical therapist fees and renewal cycle. “(1) Licenses must be renewed every year on the practitioner’s birthday as provided in chapter 246-12 WAC.” Checked October 30, 2026.
  27. Washington State Legislature (Office of the Code Reviser). WAC 246-915-99005: Physical therapist assistant fees and renewal cycle. “Physical therapist assistant fees and renewal cycle. ... (1) Licenses must be renewed every year on the practitioner’s birthday as provided in chapter 246-12 WAC.” Checked October 30, 2026.
  28. Washington State Department of Health. Physical Therapist and Physical Therapist Assistant - Continuing Education. Checked October 30, 2026.
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    “Physical therapists must complete and maintain proof of 32 hours of continuing education (CE) every two years to maintain their license. Physical therapists must also complete 200 hours involving the application of physical therapy knowledge and skills which may be obtained through employment or through non-clinical activities every two years. ... Physical therapist assistants must complete and maintain proof of 24 hours of continuing education (CE) every two years to maintain their license. ... All physical therapists and physical therapist assistants must complete 2 hours of health equity continuing education every two years.”
  29. Washington State Legislature (Office of the Code Reviser). WAC 246-915-181: Supervision responsibilities. Checked October 30, 2026.
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    “(a) Interpretation of referrals; (b) Initial examination, problem identification, and diagnosis for physical therapy; (c) Development or modification of a plan of care that is based on the initial examination and includes the goals for physical therapy intervention; ... (2) If patient care given by the physical therapist assistant, or other assistive personnel, supervision by the physical therapist requires that the patient reevaluation is performed: (a) The later of every fifth visit or every thirty days if a physical therapist has not treated the patient for any of the five visits or within the thirty days; ... (5) Supervision of assistive personnel means: (a) Physical therapist assistants may function under direct or indirect supervision; ... at any one time, the physical therapist may supervise up to a total of three assistive personnel, who may be physical therapist assistants, other assistive personnel, or physical therapy aides.”
  30. Washington State Legislature (Office of the Code Reviser). WAC 246-847-990: Occupational therapy fees and renewal cycle. “(1) Licenses must be renewed every two years on the practitioner’s birthday as provided in WAC 246-12-020 through 246-12-051 .” Checked October 30, 2026.
  31. Washington State Department of Health. Occupational Therapist and Occupational Therapy Assistant - Continuing Education. “Licensed occupational therapists and assistants must complete and maintain proof of 24 hours of continuing education (CE) or continuing competency every two years to maintain their license.” Checked October 30, 2026.
  32. Washington State Legislature (Office of the Code Reviser). WAC 246-847-065: Continued competency. Checked October 30, 2026.
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    “A minimum of 20 hours must directly relate to the practice of occupational therapy as defined in RCW 18.59.020 and WAC 246-847-010 . ... (2) As of January 1, 2024, occupational therapists and occupational therapy assistants are required to obtain at least two hours in health equity continuing education training every four years.”
  33. Washington State Legislature (Office of the Code Reviser). WAC 246-847-135: Standards of supervision. Checked October 30, 2026.
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    “(1) A licensed occupational therapy assistant must be in regular consultation, as defined by WAC 246-847-010 , with an occupational therapist licensed in the state of Washington. Regular consultation must be documented and the documentation must be kept in a location determined by the supervising occupational therapist or occupational therapy assistant.”
  34. Washington State Legislature (Office of the Code Reviser). WAC 246-847-010: Definitions. “(10) "Regular consultation with an occupational therapy assistant" means at least monthly contact with the supervising occupational therapist licensed in the state of Washington, with further supervision available as needed.” Checked October 30, 2026.
  35. Washington State Legislature (Office of the Code Reviser). WAC 246-828-990: Hearing aid specialist, audiologist, speech-language pathologist, and speech-language pathology assistant fees and renewal cycle. “(1) Credentials must be renewed every year on the practitioner’s birthday as provided in WAC 246-12-030 .” Checked October 30, 2026.
  36. Washington State Department of Health. Hearing and Speech Services - Continuing Education. Checked October 30, 2026.
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    “Audiologists, hearing aid specialists, speech-language pathologists, and speech-language pathology assistants must complete a minimum of 30 hours of continuing education every three years within the following topics: One hour must be earned by taking and passing the jurisprudence examination.* At least one hour on infection control. Up to five hours of multicultural education aimed at removing barriers to access to care. At least 2 hours of health equity training as specified in WAC 246-12-800 through WAC 246-12-830 . At least 25 hours relating to profession specific skills and competencies.”
  37. Washington State Legislature (Office of the Code Reviser). WAC 246-828-112: Speech-language pathology assistants - Minimum standards of practice. Checked October 30, 2026.
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    “(2) A speech-language pathology assistant may only perform procedures or tasks delegated by the speech-language pathologist ... (5) The following procedures or tasks may only be performed under direct supervision and at the speech-language pathologist’s discretion: ... (6) The following procedures or tasks may be performed under direct or indirect supervision at the discretion of the supervising speech-language pathologist: ... (c) Implement treatment plans and protocols including individualized education programs (IEP) or individualized family service plans (IFSP) developed by the speech-language pathologist. ... (7) The following procedures and tasks are excluded from the speech-language pathology assistant scope of practice: (a) Tasks that require diagnosis, evaluation, or clinical interpretation. (b) Screening and diagnosis of feeding and swallowing disorders. (c) Development or modification of treatment plans.”
  38. Washington State Legislature (Office of the Code Reviser). RCW 18.59.100: Duty to refer medical cases. Checked October 30, 2026.
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    “An occupational therapist shall, after evaluating a patient and if the case is a medical one, refer the case to a physician for appropriate medical direction if such direction is lacking. Treatment by an occupational therapist of such a medical case may take place only upon the referral of a physician, osteopathic physician, podiatric physician and surgeon, naturopath, chiropractor, physician assistant, psychologist, optometrist, or *advanced registered nurse practitioner licensed to practice in this state.”
  39. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). “HCA pays for outpatient rehabilitation as described in WAC 182-545-200 when the services are: ... Ordered by a physician, physician assistant (PA), or an advanced registered nurse practitioner (ARNP). ... Begun within 30 days of the date ordered.” Checked October 30, 2026.
  40. Washington State Legislature (Office of the Code Reviser). WAC 246-828-105: Speech-language pathology - Minimum standards of practice. Checked October 30, 2026.
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    “Licensed speech-language pathologists are independent practitioners who provide a comprehensive array of services related to the identification, assessment, habilitation and rehabilitation, of communication disorders and dysphagia. ... Speech-language pathologists provide services to individuals of all ages. ... (6) All services must be provided with referral to other qualified resources when appropriate.”
  41. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). “HCA pays for outpatient rehabilitation as described in WAC 182-545-200 when the services are: ... Ordered by a physician, physician assistant (PA), or an advanced registered nurse practitioner (ARNP). ... Begun within 30 days of the date ordered.” Checked October 30, 2026.
  42. Washington State Health Care Authority. Enroll as a billing provider. Checked October 30, 2026.
  43. 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.”.
  44. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). Checked October 30, 2026.
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    “When a client meets the criteria for additional units of outpatient rehabilitation, providers must use the EPA process. The EPA units may be used once per client, per calendar year for each therapy type. When a client’s situation does not meet the conditions for EPA, a provider must request a limitation extension (LE). ... A completed Outpatient Rehabilitation Authorization Request form, HCA 13-786, and all the documentation listed on this form and any other medical justification is required for an LE.”
  45. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). “Most Apple Health clients are enrolled in one of HCA’s contracted managed care organizations (MCOs). ... Send claims to the client’s MCO for payment. Call the client’s MCO to discuss payment prior to providing the service.” Checked October 30, 2026.
  46. Washington State Health Care Authority. Provider billing guides and fee schedules. Checked October 30, 2026.
  47. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). Checked October 30, 2026.
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    “Providers must use the appropriate modifier when billing the Health Care Authority: Modality Modifier Physical Therapy GP Physical Therapy Assistant CQ Occupational Therapy GO Occupational Therapy Assistant CO Speech Therapy GN ... Providers must use the referring provider’s national provider identifier (NPI) on all claims to be paid. If the referring provider’s NPI is not listed on the claim, the claim may be denied.”
  48. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). Checked October 30, 2026.
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    “The CQ or CO modifier must be included on the claim line of the service along with the appropriate GP or GO therapy modifier to identify those PTA or OTA services furnished under a PT or OP plan of care. Claims that do not reflect this combination will be rejected/returned as unprocessed.”
  49. Washington State Health Care Authority. School-based services. Checked October 30, 2026.
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    “School-based health care services (SBHS) is an optional Apple Health program that provides reimbursement to public schools for certain early intervention health-related services or special education health-related services. This program is fee-for-service and is not covered through managed care. SBHS reimburses contracted school districts, educational service districts (ESD), charter schools, and Tribal schools for Apple Health covered services provided to students with Title XIX (19) Medicaid (CNP/MNP) coverage and the services are included in the student’s current individualized education program (IEP) or individualized family service plan (IFSP).”
  50. Washington State Health Care Authority. Outpatient Rehabilitation Billing Guide (July 10, 2026). Checked October 30, 2026.
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    “HCA pays for evaluation, re-evaluation, and treatment of some physical therapy (PT), occupational therapy (OT), and speech therapy (ST) services when provided via audio-visual telemedicine. ... Audio-only telemedicine for the evaluation of speech is: • Allowed for patients who have already had a face-to-face (in-person), initial evaluation with the provider. • Permitted for less than 50% of the visits per year. • Not allowed for outpatient physical or occupational therapy.”
  51. Washington State Legislature (Office of the Code Reviser). Chapter 18.134 RCW: Uniform Telehealth Act (RCW 18.134.040 and 18.134.050). Checked October 30, 2026.
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    “(1) A health care practitioner who provides telehealth services to a patient located in this state shall provide the services in compliance with the professional practice standards applicable to a health care practitioner who provides comparable in-person health care in this state. Professional practice standards and law applicable to the provision of health care in this state, including standards and law relating to prescribing medication or treatment, identity verification, documentation, informed consent, confidentiality, privacy, and security, apply to the provision of telehealth services in this state. ... An out-of-state health care practitioner may provide telehealth services to a patient located in this state if the out-of-state health care practitioner: (1) Holds a current license or certification required to provide health care in this state or is otherwise authorized to provide health care in this state, including through a multistate compact of which this state is a member ...”
  52. Washington State Legislature (Office of the Code Reviser). Chapter 18.134 RCW: Uniform Telehealth Act (RCW 18.134.070). Checked October 30, 2026.
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    “(2) This chapter does not permit a health care practitioner to bill a patient directly for a telehealth service that is not a permissible telemedicine service under chapter 48.43 , 41.05, or 74.09 RCW without receiving patient consent to be billed prior to providing the telehealth service.”
  53. Washington State Legislature (Office of the Code Reviser). WAC 246-915-187: Use of telehealth in the practice of physical therapy. Checked October 30, 2026.
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    “(1) Licensed physical therapists and physical therapist assistants may provide physical therapy via telehealth following all requirements for standard of care, including those defined in chapter 18.74 RCW and this chapter. (2) The physical therapist or physical therapist assistant shall identify in the clinical record that the physical therapy occurred via telehealth.”
  54. Washington State Legislature (Office of the Code Reviser). WAC 246-847-176: Telehealth. Checked October 30, 2026.
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    “(2) An occupational therapist or occupational therapy assistant using telehealth to provide therapy to patients in Washington must be licensed to provide occupational therapy in Washington. ... (4) The occupational therapist or occupational therapy assistant must identify in the clinical record that the occupational therapy occurred via telehealth.”
  55. Washington State Legislature (Office of the Code Reviser). RCW 48.43.735: Reimbursement of health care services provided through telemedicine or store and forward technology. Checked October 30, 2026.
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    “(1)(a) For health plans issued or renewed on or after January 1, 2017, a health carrier shall reimburse a provider for a health care service provided to a covered person through telemedicine or store and forward technology if: (i) The plan provides coverage of the health care service when provided in person by the provider; (ii) The health care service is medically necessary; ... (b)(i) Except as provided in (b)(ii) of this subsection, for health plans issued or renewed on or after January 1, 2021, a health carrier shall reimburse a provider for a health care service provided to a covered person through telemedicine the same amount of compensation the carrier would pay the provider if the health care service was provided in person by the provider. (ii) Hospitals, hospital systems, telemedicine companies, and provider groups consisting of eleven or more providers may elect to negotiate an amount of compensation for telemedicine services that differs from the amount of compensation for in-person services.”
  56. Washington Department of Revenue. Apply for a business license. Checked October 30, 2026.
  57. Washington State Legislature (Office of the Code Reviser). WAC 458-20-151: Dentists, audiologists, and other health care providers - Dental laboratories and dental technicians. Checked October 30, 2026.
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    “(iii) Health care provider. A "health care provider" is a person licensed under the provisions of Title 18 RCW to provide health care services to humans in the ordinary course of business or practice of a profession. ... (a) Business and occupation tax. Dentists, audiologists, and other health care providers are subject to the service and other activities B&O tax on their gross income from performing dental and other health care services. ... These are sales of tangible personal property only when the dentist, audiologist, or other health care provider does not supply or administer the drug, medicine, or other item in the course of delivering health care services to the buyer. The gross proceeds of these retail sales of tangible personal property are subject to the retailing B&O tax. In addition, the dentist, audiologist, or other health care provider must collect and remit retail sales tax, unless the sale is specifically exempt by law.”
  58. Washington State Legislature (Office of the Code Reviser). RCW 82.08.0283: Exemptions - Certain medical items. Checked October 30, 2026.
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    “(1) The tax levied by RCW 82.08.020 shall not apply to sales of: (a) Prosthetic devices prescribed, fitted, or furnished for an individual by a person licensed under the laws of this state to prescribe, fit, or furnish prosthetic devices, and the components of such prosthetic devices ...”
  59. Washington State Department of Labor & Industries. Do I Need a Workers’ Comp Account?. “Washington State does not allow private workers’ compensation coverage. You must purchase your coverage from L&I or be a certified self-insured employer.” Checked October 30, 2026.
  60. Washington State Legislature (Office of the Code Reviser). RCW 51.14.010: Duty to secure payment of compensation - Options. Checked October 30, 2026.
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    “Every employer under this title shall secure the payment of compensation under this title by: (1) Insuring and keeping insured the payment of such benefits with the state fund; or (2) Qualifying as a self-insurer under this title.”
  61. Washington State Legislature (Office of the Code Reviser). RCW 51.12.020: Employments excluded. “The following are the only employments which shall not be included within the mandatory coverage of this title: ... (5) Sole proprietors or partners.” Checked October 30, 2026.
  62. 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.”.
  63. 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.”.
  64. Washington State Legislature (Office of the Code Reviser). RCW 70.02.020: Disclosure by health care provider. Checked October 30, 2026.
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    “(1) Except as authorized elsewhere in this chapter, a health care provider, an individual who assists a health care provider in the delivery of health care, or an agent and employee of a health care provider may not disclose health care information about a patient to any other person without the patient’s written authorization.”
  65. Washington State Legislature (Office of the Code Reviser). Chapter 19.373 RCW: Washington My Health My Data Act (RCW 19.373.010 and 19.373.100). Checked October 30, 2026.
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    “(23) "Regulated entity" means any legal entity that: (a) Conducts business in Washington, or produces or provides products or services that are targeted to consumers in Washington; and (b) alone or jointly with others, determines the purpose and means of collecting, processing, sharing, or selling of consumer health data. ... (1) This chapter does not apply to: (a) Information that meets the definition of: (i) Protected health information for purposes of the federal health insurance portability and accountability act of 1996 and related regulations; (ii) Health care information collected, used, or disclosed in accordance with chapter 70.02 RCW ...”
  66. Washington State Legislature (Office of the Code Reviser). RCW 19.255.010: Personal information - Notice of security breaches. Checked October 30, 2026.
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    “(1) Any person or business that conducts business in this state and that owns or licenses data that includes personal information shall disclose any breach of the security of the system to any resident of this state whose personal information was, or is reasonably believed to have been, acquired by an unauthorized person and the personal information was not secured. ... (7) Any person or business that is required to issue a notification pursuant to this section to more than five hundred Washington residents as a result of a single breach shall notify the attorney general of the breach no more than thirty days after the breach was discovered. ... (8) Notification to affected consumers under this section must be made in the most expedient time possible, without unreasonable delay, and no more than thirty calendar days after the breach was discovered ...”
  67. Washington State Legislature (Office of the Code Reviser). RCW 26.44.030: Reports - Duty and authority to make. Checked October 30, 2026.
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    “(1)(a) When any member of the clergy, practitioner, county coroner or medical examiner, law enforcement officer, professional school personnel, registered or licensed nurse, ... has reasonable cause to believe that a child has suffered abuse or neglect, he or she shall report such incident, or cause a report to be made, to the proper law enforcement agency or to the department as provided in RCW 26.44.040 . ... (h) The report must be made at the first opportunity, but in no case longer than 48 hours after there is reasonable cause to believe that the child has suffered abuse or neglect.”
  68. Washington State Legislature (Office of the Code Reviser). RCW 26.44.020: Definitions. “(22) "Practitioner of the healing arts" or "practitioner" means a person licensed by this state to practice podiatric medicine and surgery, optometry, chiropractic, nursing, dentistry, osteopathic medicine and surgery, or medicine and surgery or to provide other health services.” Checked October 30, 2026.
  69. Washington State Legislature (Office of the Code Reviser). RCW 48.21.310: Neurodevelopmental therapies - Employer-sponsored group contracts. Checked October 30, 2026.
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    “(1) Each employer-sponsored group policy for comprehensive health insurance which is entered into, or renewed, on or after twelve months after July 23, 1989, shall include coverage for neurodevelopmental therapies for covered individuals age six and under. (2) Benefits provided under this section shall cover the services of those authorized to deliver occupational therapy, speech therapy, and physical therapy. ... (5) In recognition of the intent expressed in subsection (4) of this section, benefits provided under this section may be subject to contractual provisions establishing annual and/or lifetime benefit limits.”
  70. Washington State Legislature (Office of the Code Reviser). RCW 48.44.450: Neurodevelopmental therapies - Employer-sponsored group contracts. “(1) Each employer-sponsored group contract for comprehensive health care service which is entered into, or renewed, on or after twelve months after July 23, 1989, shall include coverage for neurodevelopmental therapies for covered individuals age six and under.” Checked October 30, 2026.
  71. Washington State Legislature (Office of the Code Reviser). RCW 48.46.520: Neurodevelopmental therapies - Employer-sponsored group contracts. “(1) Each employer-sponsored group contract for comprehensive health care service which is entered into, or renewed, on or after twelve months after July 23, 1989, shall include coverage for neurodevelopmental therapies for covered individuals age six and under.” Checked October 30, 2026.
  72. Centers for Medicare & Medicaid Services. Who are the MACs: A/B MAC Jurisdiction F (JF). “Contract Awardee: Noridian Healthcare Solutions, LLC , Contract Number 75FCMC25CJ010 ... JF processes FFS Medicare Part A and Part B claims for Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming ...” Checked October 30, 2026.
  73. Washington State Department of Labor & Industries. Policy 2026. “2026 Fee Schedules Effective July 1, 2026 This site contains the policies, payment methods, billing codes, and maximum fees used to pay health care and vocational providers who treat injured workers.” Checked October 30, 2026.
  74. Washington State Department of Labor & Industries. Payment Policies, Chapter 20: Physical Medicine (2026). Checked October 30, 2026.
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    “Physical medicine services billed under CPT® codes 97010-97799 require a referral from the worker’s attending provider. Additional prior authorization may be required. ... No authorization is needed for the first 12 visits if the claim is open and allowed and treatment is for an accepted condition on the claim. ... Visits 13-24 Prior authorization from the insurer is required for additional visits.”
  75. APTA Washington. APTA Washington (the state association's site). Checked October 30, 2026.
  76. the Washington Occupational Therapy Association. the Washington Occupational Therapy Association (the state association's site). Checked October 30, 2026.
  77. the Washington Speech-Language Hearing Association. the Washington Speech-Language Hearing Association (the state association's site). Checked October 30, 2026.
  78. DrSensory. Occupational therapy clinics in Washington, with the physical therapy and speech therapy pages for the state (the directory's state pages, built from the addresses it holds). Checked October 30, 2026.
  79. DrSensory. Clinic Directory Pricing. “Claiming your listing is free. The subscription is $349.99 a year or $29.99 a month for your first location, and $99.99 a year or $9.99 a month for each additional location, not per therapist.” Checked October 30, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. It is general guidance on running a therapy clinic in Washington, not legal, compliance, billing or financial advice. Rules change; the clinic confirms each with its source before acting on it.