The board’s rules do not require the referring practitioner to sign the plan of care, nor do the rules address when a referral source needs to approve continuation of services. If a referral does not specifically address duration or frequency of treatment, it is up to the PT’s professional judgment how often to notify the doctor of the patient’s status and need for further treatment. However, if a referral is specifically limited to a duration of time, it could be said to expire at the end of that time. If a referral expires, it cannot be used as the authorization to treat unless the PT receives approval to continue from the doctor.
Payers such as Medicare or Medicaid may have rules that require the referral source to sign the Plan of Care, and to do other things not required by the PT board. You must follow payer rules to be eligible for reimbursement, but those rules are independent of the board’s rules regarding the legal practice of physical therapy in Texas. For information about payer requirements, you must contact the payer. (3/3/2010)