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35.2.2 Physical Therapy Documentation Requirements
Authorization is not required for therapy services delivered to clients 20 years of age or younger, although authorization is recommended through THSteps-CCP for services delivered in the home. Clients 21 years of age and older receive PT through Home Health Services.
Submit the following documentation for claims payment:
• A physician's prescription:
•Clients 20 years of age or younger who receive PT services often have chronic conditions that require ongoing medical supervision.
•The prescription must address medical necessity.
•A new prescription is required at least every six months.
•Therapy treatment plan:
•The initial THSteps-CCP treatment plan must include a copy of a current evaluation and documentation of the treatment goals and anticipated measurable progress.
•Renewal of THSteps-CCP therapy services requires a summary statement of the measurable progress during the previous treatment period and documentation of new treatment goals with anticipated measurable progress for the renewal period.
•A treatment plan is valid for up to six months.
Refer to: "Home Health Services" for information about PT services provided in the home setting.
"THSteps-Comprehensive Care Program (CCP)" for information about PT, occupational therapy (OT), and speech language-pathology (SLP) services.
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