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News: Legislative & Advocacy Updates

Practice Alert: An OT Referral Barrier Removed

Wednesday, January 28, 2015  
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Legislative Update December 2014
By Clark Collins, PA-C


Practice Alert: An OT Referral Barrier Removed

A few years ago, WAPA helped make changes to state statutes that allowed PAs to order physical therapy services without a physician co signature.  After that change was enacted, it became clear that there was some confusion and concern about PAs being able to order occupational therapy (OT).  Some PAs around the state have had difficulty ordering OT without a physician co signature because the state administrative rules having to do with OT referrals were unclear regarding exactly who could write for a referral and order occupational therapy services.  Depending on how your hospital or clinic administration interpreted the rules, as a PA you may or may not have had difficulty with this issue.  I am happy to report that this problem has been addressed and clarified.


Physician assistants can now, with no uncertainty, order occupational therapy services without a physician co signature based on the new language that went into effect in late 2014.  This change cleared up any confusion there may have been previously about who could order OT services.  The new OT language having to do with referrals reads as follows:


OT 4.03

2) REFERRALS AND ORDERS. (a) Evaluation, rehabilitation treatment, and implementation of treatment with individuals with specific medical conditions shall be based on an order from a physician, dentist, podiatrist, or any other qualified health care professional.

(b) Referrals may be accepted from advanced practice nurses, chiropractors, optometrists, physical therapists, physician assistants, psychologists, or other health care professionals.

(c) Although an order is not required, an occupational therapist or occupational therapy assistant may accept a referral for the purpose of providing services which include consultation, habilitation, screening, client education, wellness, prevention, environ- mental assessments, and work−related ergonomic services.

(d) Orders shall be in writing. However, verbal orders may be accepted if they are followed by a written and signed order by the ordering professional within 3 days from the date on which the client consults with the occupational therapist or occupational therapy assistant.

(e) Orders or referrals from another health care professional are not required for evaluation or intervention if an occupational therapist or occupational therapy assistant provides services in an educational environment, including the child’s home, for children and youth with disabilities pursuant to rules promulgated by the federal individuals with disabilities education act, the department of public instruction and the department of health services, or pro- vides services in an educational environment for children and youth with disabilities pursuant to the code of federal regulations.

If you are a PA who had difficulty with OT orders in your practice because of the previous language, please share this information with your administration and collaborating physicians.   WAPA thanks and congratulates the Wisconsin Occupational Therapy Association for making this and many other meaningful changes to their administrative rules.