Medicaid Child Health Services
Therapy Services

The purpose of the therapy services program is to provide medically necessary occupational therapy (OT), physical therapy (PT), respiratory therapy (RT) and speech-language pathology (SLP) services to Medicaid recipients from birth through age 20. Regardless of age, the therapy services program provides services to all Medicaid recipients for SLP services for the provision of augmentative and alternative communication systems and PT and OT services for wheelchair evaluations and fittings.

Please consult the Therapy Services Coverage and Limitations Handbook for more information on Therapy Services.

Therapy Services Policy Webinars

A recorded version of the webinar is posted on the Medicaid Provider Training e-Library. The link will take you to the Provider Training e-Library main page. From there, click on the Previous Training Materials tab at the top and the video is at the bottom of the page. The PowerPoint used at the webinar is available below for downloading.

Therapy Services Provider Qualifications

Medicaid reimburses for physical therapy services provided by licensed, Medicaid-participating physical therapists and by supervised physical therapy assistants.

Medicaid reimburses for speech language-pathology services provided by licensed, Medicaid-participating speech-language pathologists and by supervised speech-language pathologist assistants.

Medicaid reimburses for occupational therapy services provided by licensed, Medicaid-participating occupational therapists and by supervised occupational therapy assistants.

Medicaid reimburses for respiratory therapy services that are rendered by a licensed registered respiratory therapist.

Please consult the Therapy Services Coverage and Limitations Handbook for more information on Therapy Services.

Utilization Management Program

Florida Medicaid has implemented a utilization management program for therapy services as mandated by the Florida Legislature in section 409.912(40), Florida Statutes, to ensure recipients receive appropriate care in line with the standards set forth in the Florida Medicaid Therapy Services Coverage and Limitations Handbook.

Utilization Management Legislation

The authorizing language for the Florida Medicaid Therapy Services Utilization Management Program can be found in section 409.912(40), Florida Statutes, on the official internet website of the Florida Legislature, Online Sunshine.

Prior Authorization Vendor

The Agency for Health Care Administration (Agency) has entered into a contract with eQHealth Solutions, Inc. for utilization management, including prior authorization of therapy services.

The primary purpose of the utilization management program is to safeguard against the provision of unnecessary medical services or inappropriate use of Medicaid services and to ensure appropriate care.

The Agency will provide periodic updates through the Florida Medicaid fiscal agent’s Web portal, provider bulletins, provider notification letters, and Medicaid Health Care Alerts. The links below are to give providers more information.

Durable Medical Equipment Evaluation Training

In order to assist Therapy Providers with the Durable Medical Equipment (DME) Program’s wheelchair and augmentative and alternative communication (AAC) device evaluation procedures, the DME program put together presentations that illustrate key components of these processes.

Rule Development

Activities on the Administrative Code of the State of Florida can be tracked on the state’s e-rulemaking Web site.  To track rule development that affects the Medicaid Therapy Services program, please visit the Florida Administrative Weekly website.

Handbooks

Florida Medicaid handbooks furnish the Medicaid provider with the policies and procedures needed to receive reimbursement for covered services provided to eligible Florida Medicaid recipients.

The Medicaid Therapy Services Coverage and Limitations Handbook explains covered services and policies for the Therapy Services program.

The Medicaid Provider General Handbook contains requirements of the Florida Medicaid Program that apply to all providers.  Providers must follow the provisions of this handbook in addition to their services specific handbook.

The Provider Reimbursement Handbook, CMS 1500 contains generic eligibility information, general Medicaid information, and claim instructions.

Florida Medicaid Health Care Alerts

Would you like Florida Medicaid Health Care Alerts sent directly to your email account?  The Florida Medicaid program has an email alert system to supplement the present method of receiving Provider Alerts and to notify registered providers or interested parties of "late-breaking" information. An email will be delivered to your mailbox when Medicaid policy clarifications or other health care information is available that is appropriate for your selected provider type. Visit the Florida Medicaid Health Care Alerts website to subscribe. 

Contact Us

Have questions about the Therapy Services program?  Please contact your local Medicaid area office for assistance. 

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