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December 2016 Texas Medicaid Provider Procedures Manual

Physical Therapy, Occupational Therapy, and Speech Therapy Services Handbook : 4 * Therapy Services Overview : 4.6 Criteria for Discontinuation of Therapy

4.6
Discontinuation of therapy may be considered in one or more of the following situations:
Client can continue therapy with a home treatment program and deficits no longer require a skilled therapy intervention and, for clients who are 20 years of age and younger only, maintain status.
Client is unable to participate in the treatment plan or plan of care due to medical, psychological, or social complications; and responsible adult has had instruction on the home treatment program and the skills of a therapist are not needed to provide or supervise the service.
Plateau in response to therapy/lack of progress towards therapy goals. Indication for therapeutic pause in treatments or, for those under age 21, transition to chronic status and maintenance therapy.
The therapy requested is for general conditioning or fitness, or for educational, recreational or work-related activities which does not require the skills of a therapist.

Texas Medicaid & Healthcare Partnership
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