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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 3. School Health and Related Services (SHARS) : 3.3 Services/Benefits, Limitations, and Prior Authorization : 3.3.5 Occupational Therapy (OT) : 3.3.5.3 Occupational Therapy Billing Table

3.3.5.3
Individual
or Group
Therapist or Licensed/Certified Assistant
Providers must use a 15‑minute unit of service for billing.
Refer to:
The recommended maximum billable time for OT evaluation is three hours, which may be billed over several days. The recommended maximum billable time for direct therapy (individual or group) is a total of one hour per day. Providers must submit documentation of the reasons for the additional time, if more than the recommended maximum time is billed.

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