text: WSR 00-04-019
  [ Filed January 24, 2000, 10:35 a.m. ]
  Purpose: The department is establishing new chapter 388-545 WAC to combine all medical therapy rules. Therefore, WAC 388-86-090 Physical therapy and 388-87-090 Payment -- Physical therapy and related services, are being repealed and WAC 388-545-0500 Physical therapy, is being established. The new chapter reorganizes rule sections and updates the language to comply with the Governor's Executive Order 97-02.
  Citation of Existing Rules Affected by this Order: Repealing WAC 388-86-090 and 388-87-090.
  Adopted under notice filed as WSR 99-20-106 on October 6, 1999.
  Changes Other than Editing from Proposed to Adopted Version: (1) WAC 388-545-500 (1)(b): "A physical therapy therapist assistant supervised by a licensed physical therapist; or"
  (2) WAC 388-545-500 (1)(c), deleted: "A physical therapy aide, in schools, trained and supervised by a licensed physical therapist."
  (3) WAC 388-545-500 (3)(f), added (f): "For disabled children, age two and younger, in natural environments including the home and community settings in which children without disabilities participate, to the maximum extent appropriate to the needs of the child."
  (4) WAC 388-545-500 (4)(b): "Medically necessary and prescribed ordered by a physician, physicians's assistant (PA), or an advanced registered nurse practitioner (ARNP);"
  (5) WAC 388-545-500 (4)(c): "Begun within thirty days of the date prescribed ordered;
  (6) WAC 388-545-500 (4)(e), deleted: "Within accepted medical physical therapy standards."
  (7) WAC 388-545-500(5), changed wording: "Physical therapy for Providers must document in a client's medical file that physical therapy services provided to clients age twenty-one and older when prescribed by a physician, PA, or an ARNP must are medically necessary. Such documentation may include justification that physical therapy services:"
  (8) WAC 388-545-500 (5)(d): "Be a Are part of a treatment program..."
  (9) WAC 388-545-500(8): "MAA covers, without requiring prior authorization, the following prescribed ordered physical therapy services per client, per diagnosis, per calendar year, for clients..."
  (10) WAC 388-545-500(9), reworded: "Additional medically necessary physical therapy services, regardless of the diagnosis, require prior authorization For clients age twenty-one years of age and older., MAA covers physical therapy services which exceed the limitations established in subsection (8) of this section if the provider requests prior authorization and MAA approves the request.
  (11) WAC 388-545-500(1), deleted: "The following providers are eligible to enroll with the medical assistance administration (MAA) to provide physical therapy services:..."
  The changes were made because:
  (1) WAC 388-545-500 (1)(b), changed reference to "physical therapy assistant" to "physical therapist assistant" per public request to use same language as cited in RCW.
  (2) WAC 388-545-500 (1)(c), per public request, deleted requirement, "in schools," as physical therapist assistants are not limited to the school setting.
  (3) WAC 388-545-500 (3)(f), added section (f), per public request, to incorporate language allowing disabled children age two and younger to receive physical therapy in natural environments, per 34 C.F.R. 303.12(b).
  (4) WAC 388-545-500 (4)(b), changed "prescribed" to "ordered." Public commented that a physician "refers" a patient to a physical therapist, rather than "prescribing" certain physical therapy treatments. MAA determined that using the term "ordered" to replace "prescribed" is appropriate.
  (5) WAC 388-545-500 (4)(c), changed "prescribed" to "ordered." See (4) above.
  (6) WAC 388-545-500 (4)(e), deleted "medical" per public request as it is not needed in language.
  (7) WAC 388-545-500(5), changed wording, per public request, to eliminate language that required physical therapy services provided to clients age twenty-one and older to meet the specific requirements of (5)(a), (b), (c), or (d). New language states that providers must document in a client's medical file that physical therapy services for client's age twenty-one and older are medically necessary and cites examples of justification that may be included in the documentation.
  (8) WAC 388-545-500 (5)(d), changed wording from "Be a part of a treatment program" to "Are part of a treatment program" because the language changes in subsection (5) requires the wording in (5)(d) to refer to "such documentation."
  (9) WAC 388-545-500(8), changed "prescribed" to "ordered," for reasons stated in (4) above.
  (10) WAC 388-545-500(9), deleted the phrase, "regardless of the diagnosis," per public request, and rewrote to clarify that the provider must request prior authorization for physical therapy services which exceed the limitations established in subsection (8), and MAA must approve the request.
  (11) WAC 388-545-500(1), deleted the phrase, "to enroll with the medical assistance administration (MAA)" as the rule already states that "providers are eligible." A provider is already enrolled with MAA so an explanation is not needed here.
  Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 2. Effective Date of Rule: Thirty-one days after filing.
  (e) By a school district or educational service district as part of an individual education or individualized family service plan as described in WAC 388-86-022; or