Ohio Code 5162.366 – Referrals for certain services under the Medicaid School Program
(A) Subject to division (B) of this section and for the purpose of a medicaid recipient receiving, in accordance with the recipient’s individualized education program, physical therapy services, occupational therapy services, speech-language pathology services, or audiology services under the medicaid school component of the medicaid program:
Terms Used In Ohio Code 5162.366
- Ordering or referring only provider: means a medicaid provider who orders, prescribes, refers, or certifies a service or item reported on a claim for medicaid payment but does not bill for medicaid services. See Ohio Code 5162.01
(1) A physical therapist is a licensed practitioner of the healing arts for the purpose of 42 C.F.R. § 440.110(a)(1) and may make a referral for physical therapy services for the recipient.
(2) An occupational therapist is a licensed practitioner of the healing arts for the purpose of 42 C.F.R. § 440.110(b)(1) and may make a referral for occupational therapy services for the recipient.
(3) A speech-language pathologist is a licensed practitioner of the healing arts for the purpose of 42 C.F.R. § 440.110(c)(1) and may make a referral for speech-language pathology services for the recipient.
(4) An audiologist is a licensed practitioner of the healing arts for the purpose of 42 C.F.R. § 440.110(c)(1) and may make a referral for audiology services for the recipient.
(B) To be able to make a referral for a service under this section, a physical therapist, occupational therapist, speech-language pathologist, or audiologist must have a provider agreement. This does not preclude a physical therapist, occupational therapist, speech-language pathologist, or audiologist from being an ordering or referring only provider.