TMPPM 2008 > Texas Medicaid Services > Texas Medicaid (Title XIX) Home Health Services > Benefits

24.5.10.1 Occupational Therapy Prior Authorization Procedures

To obtain prior authorization for the initial and recertification of OT services provided through a home health agency, providers should contact the TMHP Home Health Services Prior Authorization Department at 1-800-925-8957. Home health agencies must provide accurate diagnostic information (including ICD-9-CM diagnosis codes), OT procedure codes, and an initial or subsequent plan of care to include OT goals.

Use the codes listed under "Physical Therapy/Occupational Therapy Procedure Codes" to submit claims for OT services that are provided through a home health agency. Bill OT services on a UB-04 CMS-1450 claim form. Use procedure code 1-97003 when requesting prior authorization and billing for wheelchair evaluations.