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Services, adopted by reference in 7 AAC 160.900, if those services and supplies, except the initial evaluation, are

(1) prescribed by a physician, an advanced practice registered nurse, or a physician assistant who may prescribe those services and supplies within the scope of the practitioner’s license;

(2) delivered by a physical therapist, an occupational therapist, or a speech-language pathologist who holds an active license to practice issued by the jurisdiction in which services are provided and who provides direct services only within the scope of that license; if services are provided in this state the individual must hold an active license under AS 08; and

(3) provided in accordance with the initial evaluation and treatment plan developed under 7 AAC 115.220. (b) The department will pay for the services of an occupational therapy assistant, physical therapy assistant, or speech-language pathologist assistant if those services are

(1) provided by an assistant who holds an active license to practice in the jurisdiction in which services are provided; if the services are provided in this state the individual must hold an active license under AS 08.84 or AS 08.11, whichever applies;

(2) performed in accordance with the requirements of AS 08.11.042, 12 AAC 54.510, 12 AAC 54.810, or 12 AAC 54.820, whichever applies, or the equivalent requirements in the jurisdiction in which services are provided; and

(3) billed through the supervising therapist who meets the requirements of (a)(2) of this section. (c) The department will not pay for the services provided by a occupational therapy aide, physical therapy aide, or a speech-language pathologist aide. (d) For an individual 21 years of age or older, the department will pay for

(1) two units of physical and occupational therapy evaluation services combined each state fiscal year;

(2) 30 combined units of physical and occupational therapy services combined each state fiscal year;

(3) additional units of physical and occupational therapy services if the department gives prior authorization based on medical justification submitted by the provider;

(4) eight units of speech-language therapy evaluation services each state fiscal year;

(5) 15 units of speech-language therapy services each state fiscal year; and

(6) additional units of speech-language therapy services if the department gives prior authorization based on medical justification submitted by the provider.