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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 2. Medicaid Children’s Services Comprehensive Care Program (CCP) : 2.3 Comprehensive Outpatient Rehabilitation Facilities (CORFs)and Outpatient Rehabilitation Facilities (ORFs) : 2.3.2 Services, Benefits, and Limitations

2.3.2
Occupational, physical, and speech therapy services are a benefit for clients who are 20 years of age or younger and who are CCP eligible when:
Documentation of medical necessity supports a condition that requires ongoing therapy or rehabilitation in the usual course, treatment, and management of the client’s condition.
Therapy may be performed by a licensed occupational therapist, physical therapist, speech therapist, or one of the following under the supervision of a licensed therapist: licensed therapy assistant or licensed speech-language pathology intern.
Services performed by an OT aide, OT orderly, OT student, OT technician, PT aide, PT orderly, PT student, PT technician, SLP aide, SLP orderly, SLP student, or SLP technician are not a benefit of Texas Medicaid.
Therapy services performed by an unlicensed provider are subject to retrospective review and recoupment.
CORF and ORF services provided at schools, homes, daycare facilities, or any other non-Medicare- approved ORF or CORF facility is not a covered CCP benefit.
Services That Are Not a Benefit
The following services are not a benefit of CCP:

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.