New York Codes, Rules and Regulations › Title 18 - DEPARTMENT OF SOCIAL SERVICES › Chapter II - Regulations of the Department of Social Services › Subchapter E - Medical Care › Article 3 - Policies and Standards Governing Provision of Medical and Dental Care › Part 505 - Charges For Professional Health Services › Section 505.11 - Rehabilitation services

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
			 Provision of care. Rehabilitation services, with the exception of services
			 provided under subparagraph (c)(1)(iv) of this section, are available only if a
			 physician provides a written order for the services to the medical assistance
			 recipient and the services are an integral part of a comprehensive medical care
			 program. Services provided under subparagraph (c)(1)(iv) of this section may be
			 made available only if a physician, registered nurse, nurse practitioner,
			 physical therapist, occupational therapist, or speech pathologist, who is
			 acting within the scope of his or her practice under New York State law,
			 recommends the medical assistance recipient for such services and the services
			 are part of an individualized education program or an interim or final
			 individualized family services plan. The health professional must be licensed,
			 registered, and/or certified in accordance with the New York State Education
			 Law and the rules of the Commissioner of Education. Such recommendation must be
			 reflected in the individualized education program or an interim or final
			 individualized family services plan. Rehabilitation services include not only
			 services to the recipient but also instructions to responsible members of the
			 family in follow-up procedures necessary for the care of the
			 recipient.
(b) Where care may be
			 provided. Rehabilitation services may be provided in the recipient's home, in a
			 hospital outpatient department, in an approved clinic or outpatient medical
			 facility not part of a hospital, in an approved medical institution or
			 facility, in an approved home health agency, in the office of a qualified
			 private practicing therapist or speech pathologist and, with respect to a child
			 receiving rehabilitation services pursuant to an individualized education
			 program or an interim or final individualized family services plan, in a
			 school, an approved pre- school or natural environment, including home and
			 community settings, where such child would otherwise be found.
(c) Who may provide care. Rehabilitation
			 services may be provided by:
(1) Qualified
			 professional personnel employed by or under contract to:
(i) an approved home health agency;
(ii) a hospital;
(iii) an approved clinic or outpatient
			 medical facility not part of a hospital; or
(iv) a school district; an approved
			 pre-school; a county in the State or the city of New York; an approved early
			 intervention program; or a municipality in the State. Such services will be
			 furnished as part of the development of or pursuant to an individualized
			 education program or an interim or final individualized family services plan.
Speech pathology services may be provided under
			   subparagraph (iv) of this paragraph by a teacher of the speech and hearing
			   impaired under the direction of a speech pathologist. Under the direction of a
			   speech pathologist means that a teacher of the speech and hearing impaired may
			   provide services as long as a speech pathologist meets with such teacher on a
			   regular basis and is available for consultation to assure that care is provided
			   in accordance with the individualized education program or an interim or final
			   individualized family services plan. Teachers of the speech or hearing impaired
			   or speech pathologists who provide services or in the case of a speech
			   pathologist under whose direction services are provided must be currently
			   registered and certified in accordance with the New York State Education Law
			   and the rules of the Commissioner of Education.