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Guidelines for Determining Frequency of Physical and Occupational Therapy

Physical and Occupational Therapy are skilled services that are designed to help your child achieve functional goals. Your child’s goals and current needs will help determine how often and how long your child will be seen by therapy. During therapy, your child will be assessed at regular intervals to determine the type and frequency of services needed.

Do I need to attend my child’s therapy sessions?

Parent involvement is an important part of a successful therapy program. Each therapy session will provide new information and ideas to get the most out of therapy for your child. The main goal of therapy is to give you education and ideas you can use at home. Studies have shown children are more successful when their parents and therapists work together.

How often will my child receive therapy?

At the evaluation, your therapist will make a plan with you for how often your child will need to receive skilled services. Considerations may include your child’s ability to participate and benefit from therapy, diagnosis, age, motivation, and parents ability to follow through with home activities/recommendations.

How long will my child receive therapy?

A time frame will be set for the number of weeks your child will receive services. At the end of that time, a re-evaluation will be done to assess progress and a new plan will be established.

Changes in frequency, duration, and ending therapy services are to be expected. Your child will go through different life phases that may require more, less, or no skilled therapy.

Therapists will base their recommendations for therapy on their clinical assessment, research available, and theGuidelines for Determining the Frequency of Therapy Services”.  There are 5 levels of frequency:

Intensive Therapy – 2-3 times per week for a limited amount of time

  1. Your child has potential for fast progress or decline due to his/her current medical condition.
  2. Your child requires frequent changes in his/her therapy plan due to progress.
  3. Family education is a large part of therapy because of the functional changes your child is making daily.

Weekly/Bi-Monthly Therapy – 1 times per week or every other week

  1. Your child will make progress towards the goals established on a weekly to every other week basis.
  2. Your child requires assistance from a skilled professional for an established period of time to work toward new, functional goals.
  3. Families will learn a home program to safely continue in the home at each session to continue to work towards the goals.

Block Therapy – Weekly, typically a 6-12 week time block

  1. Your child needs specialized treatment or group therapy to focus on a specific area with plans to move to another level following a set protocol.
  2. A few examples include vital stimulation, interactive metronome, constraint induced therapy, and group therapy.

Periodic Therapy – Monthly or at regular intervals

  1. A child whose progress is slower but continues to advance function toward goals.
  2. Families provided with updated home activities at each appointment to work toward these goals.

Consultative Therapy - As needed basis

  1. Your child will transition to consultative therapy when they have reached their functional goals and his/her family is independent with a home program to maintain your child’s current level of function.
  2. Your child may benefit from this level of service when your child has a planned medical intervention, reaches a change in life stages, improves or regresses, or new technology is available.

When will my child discharge from therapy?

Your therapist will discuss your child’s progress at each therapy session and discuss the plan for discharge.  Discharge from therapy occurs when:

  • Goals are met and expected outcomes are achieved.
  • Family decides skilled therapy services are no longer needed.
  • Therapy no longer results in functional changes or measurable outcomes per re-evaluation testing.

Your therapist will work with you on your therapy plan post discharge.


  1. Kummer, Ann Ph.D., CCC-SLP. Handout: Talking about … Guidelines for Determining the Frequency of Therapy. Cleft Palate and Craniofacial Anomalies: The Effects on Speech and Resonance, 3rd Edition. 2014.
  2. Cincinnati Children’s Hospital Medical Center, Division of Occupational and Physical Therapy Guidelines.
  3. Practice Committee of the Section on Pediatrics, APTA. Frequency and Duration of Physical Therapy Services in the Acute Care Pediatric Setting. 2013.


Insurance coverage for therapy services varies by insurance plan and employer. It is important to check with your insurance plan for your specific benefits and coverage for services at Children's Mercy. You can contact your insurance plan by calling the 1-800 number on the back of your card. Families are responsible for contacting insurance for coverage information to prevent unexpected costs. Families are encouraged to inquire about co-pays, family responsibilities, and specific coverage for diagnosis or treatments with their insurance company. 

Commonly asked questions include:

  • Do I have coverage for physical and/or occupational therapy?
  • Is there coverage for my child’s specific diagnosis or specific treatment? 
    • Please ask your therapist for specific diagnosis code or CPT codes if requested by your insurance to determine your benefits.
  • How many visits do they allow?
  • If my child needs physical and occupational therapy- will the same number of visits be allowed for both?
  • Will I have a co-pay and/or what will my payment responsibility be?

More information on Insurance and Billing More information on Medical Records