Medicaid Coverage of Physical Therapy Services Below is the basic Medicaid coverage information for speech therapy services for children and adults in each state. Medicaid managed care plans must provide the same amount of coverage but can change prior authorization requirements. Members can email us with questions or request information on Medicaid issues at any time and have access to the guides on the state Medicaid pages. |
| State | Children | Adults |
| Alabama | Alabama Medicaid covers physical therapy for children without prior authorization. |
Alabama Medicaid covers physical therapy for adults for acute condition is a hospital outpatient setting. |
| Alaska | In addition to the coverage provided to adults, children under age 21 are eligible to receive maintenance physical therapy services related to conditions caused by developmental disabilities or delays. |
Alaska Medicaid covers physical therapy services when provided by an enrolled PT or PTA. Services include evaluations, massage and manipulation, therapeutic exercise, and other forms of treatment to rehabilitate and restore normal body functions after acute physical illness or acute physical trauma. |
| Arizona | Arizona Medicaid covers outpatient physical therapy services are covered for members under the age of 21. |
Arizona covers inpatient physical therapy for all members who are receiving inpatient care at a hospital, nursing facility or custodial care facility. Outpatient PT services are covered for adult members, 21 years of age and older as follows:
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| Arkansas | Arkansas Medicaid and ARKids First-A will pay for physical therapy for patients who are younger than 21. |
Arkansas Medicaid does not cover outpatient physical therapy for adults. |
| California | California Medicaid or Medi-Cal covers physical therapy for children with prior approval. |
California Medicaid or Medi-Cal covers physical therapy for adults with prior approval. |
| Colorado | Colorado Medicaid covers physical therapy for children, prior authorization may be required. |
Colorado Medicaid covers physical therapy for children, prior authorization may be required. |
| Connecticut |
Connecticut Medicaid covers physical therapy services for children. Prior authorization is needed for more than two (2) visits per week. |
Connecticut Medicaid covers physical therapy services for adults. Prior authorization is needed for more than two (2) visits per week. |
| Delaware | Delaware Medicaid covers physical therapy services for children. |
Delaware Medicaid covers physical therapy services for adults. |
| Florida | All Florida Medicaid recipients who are 20 years of age or younger and not in a long-term care plan may receive physical therapy services. |
All Florida Medicaid recipients who are 18 years of age or older and who are in a Long-Term Care or Comprehensive Long-Term Care plan may receive physical therapy. Recipients 21 years of age and older may receive limited services pertaining to wheelchair evaluations and fittings. PT services are otherwise not covered for adults. |
| Georgia |
Georgia Medicaid covers physical therapy for children. Prior authorization after eight (8) units per month. |
Georgia Medicaid only covers adult physical therapy services, in a hospital setting, immediately following and in treatment of acute illness, injury or impairment. |
| Hawaii |
Hawaii Medicaid allows up to 36 units or 12 visits of PT and/or OT for children as long as these services(s) does not/do not exceed 36 units, or 12 visits for PT and/or OT in a 12-day period. Prior authorization is required after limits are reached. |
Hawaii Medicaid allows up to 36 units or 12 visits of PT and/or OT for adults as long as these services(s) does not/do not exceed 36 units, or 12 visits for PT and/or OT in a 12-day period. Prior authorization is required after limits are reached. |
| Idaho | Idaho Medicaid covers physical therapy for children. |
Idaho Medicaid covers physical therapy for adults. |
| Illinois | Illinois Medicaid covers physical therapy for children with prior approval. |
Illinois Medicaid covers physical therapy for adults with prior approval. |
| Indiana |
Indiana Medicaid covers rehabilitative physical therapy services for members under 21 years of age when determined medically necessary. Indiana Medicaid covers habilitative physical therapy services for members under 21 years of age on a case-by-case basis, subject to prior authorization. |
For members 21 years of age and older, Indiana Medicaid covers rehabilitative physical therapy services for no longer than two (2) years from the initiation of the therapy, unless a significant change in medical condition requires longer therapy. Habilitative therapy is not a covered service for members 21 years of age and older. |
| Iowa | Iowa Medicaid covered physical therapy for children. |
Iowa Medicaid covered physical therapy for adults. |
| Kansas |
Habilitative therapy is covered only for participants zero to under 21 years of age. Kansas Medicaid covers developmental physical therapy services are covered for children under 21 years of age. |
Kansas Medicaid covers physical therapy for adults 21 years of age and over only when rehabilitative in nature and provided following physical debilitation due to an acute physical trauma or illness. Therapy services are limited to up to six (6) consecutive months per injury or illness for participants 21 years of age and older. |
| Kentucky | Kentucky Medicaid covers physical therapy for children up to twenty (20) visits a year, prior authorization for additional visits. |
Kentucky Medicaid covers physical therapy for adults up to twenty (20) visits a year, prior authorization for additional visits. |
| Louisiana | Louisiana Medicaid covers physical therapy with prior authorization, recipients 0 through 20 years of age. |
Louisiana Medicaid only covers physical therapy for adults in outpatient hospital settings, with prior authorization. |
| Maine | Maine covers physical therapy services for children. |
Maine Medicaid covers physical therapy for adults with limitations, prior authorization is required. Services for maintenance care are limited to two (2) visits per year. Services for rehabilitation are limited to six (6) visits per condition. |
| Maryland |
Maryland Medicaid covers physical therapy services for children. Providers of physical therapy services should bill FFS Medicaid for participants under 21 years of age. |
Maryland Medicaid covers physical therapy services for adults. Therapists must contact the MCO for preauthorization for participants 21 years of age and older. |
| Massachusetts | Massachusetts Medicaid or Mass Health covers physical therapy for children with prior authorization. |
The MassHealth agency requires that the physical therapist obtain prior authorization as a prerequisite to payment for the following services to eligible MassHealth members:
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| Michigan |
Michigan Medicaid covers physical therapy for children. Outpatient: Up to 144 units of PT per calendar year period. Nursing Facility: PT performed within 60 days of the beneficiary’s admission to the facility. Home Health: Up to 24 visits of PT in one 60 consecutive day period. Prior authorization is required after the limits are reached. |
Michigan Medicaid covers physical therapy for adults. Outpatient: Up to 144 units of PT per calendar year period. Nursing Facility: PT performed within 60 days of the beneficiary’s admission to the facility. Home Health: Up to 24 visits of PT in one 60 consecutive day period. Prior authorization is required after the limits are reached. |
| Minnesota |
Minnesota Medicaid covers physical therapy for children without prior authorization. Specialized maintenance therapy coverage is limited to MHCP members aged 20 and younger. |
Minnesota Medicaid covers physical therapy for adults without prior authorization. |
| Mississippi | Mississippi Medicaid covers physical therapy for children with prior authorization. |
Mississippi Medicaid covers physical therapy for adults with prior authorization. |
| Missouri | Missouri Medicaid covered physical therapy services for children. |
Missouri Medicaid has limited physical therapy coverage for adults. Habilitative Services: The combination of all habilitative skilled therapy services for the adult expansion group is limited to a total of 20 visits per rolling year, inclusive of services from all MHD providers. Participants 19 to 20 years old in the adult expansion group may receive all medically necessary habilitative skilled therapy services. Prior authorization is not required. |
| Montana | Montana Medicaid covers physical therapy for children. |
Montana Medicaid covers physical therapy for adults. |
| Nebraska | Nebraska Medicaid covers physical therapy services for children. |
For recipients age 21 and older, Nebraska Medicaid limits coverage to a combined total of sixty (60) therapy sessions per fiscal year. The combined total of sixty (60) therapy sessions per fiscal year includes all occupational therapy, physical therapy, speech pathology, and audiology sessions provided to the recipient. |
| Nevada | Nevada Medicaid covers physical therapy for children. Prior authorization is required except for the initial evaluation and re-evaluations. |
Nevada Medicaid covers physical therapy for adults. Prior authorization is required except for the initial evaluation and re-evaluations. |
| New Hampshire |
New Hampshire Medicaid covers physical therapy services for children with limitations. Physical therapy shall be limited to eighty (80) fifteen-minute units per member per state fiscal year (July 1 – June 30). The eighty (80) units described above may be used for physical therapy, occupational therapy, services for speech, hearing and language disorders, or any combination of these services. Prior authorization is required after limits have been reached. |
New Hampshire Medicaid covers physical therapy services for adults with limitations. Physical therapy shall be limited to eighty (80) fifteen-minute units per member per state fiscal year (July 1 – June 30). The eighty (80) units described above may be used for physical therapy, occupational therapy, services for speech, hearing and language disorders, or any combination of these services. |
| New Jersey | New Jersey Medicaid covers physical therapy for children when provided by physical therapists employed in a physician’s office. |
New Jersey Medicaid covers physical therapy for adults when provided by physical therapists employed in a physician’s office. Outpatient rehabilitation benefits are limited to treatment over a period of sixty (60) consecutive business days per incident of illness or injury beginning with the first day of treatment. |
| New Mexico | New Mexico Medicaid covers physical therapy for children with prior approval. |
New Mexico Medicaid covers physical therapy for adults with prior approval. |
| New York | New York Medicaid covers physical therapy services for children. |
New York Medicaid covers physical therapy services for adults. |
| North Carolina | North Carolina Medicaid covers physical therapy services for children with prior authorization. |
North Carolina Medicaid covers physical therapy services for adults with limitations. A total maximum of thirty (30) treatment visits per calendar year combined across occupational and physical therapy habilitative services. A total maximum of thirty (30) treatment visits per calendar year combined across occupational and physical therapy rehabilitative services. |
| North Dakota |
North Dakota covers physical therapy for children. Physical therapy evaluations are limited to one (1) per calendar year. |
North Dakota covers physical therapy for adults with limitations. Physical therapy evaluations are limited to one (1) per calendar year. Physical therapy is limited to thirty (30) visits per calendar year for members age 21 and over. Prior authorization is required after limits are met. |
| Ohio |
Ohio Medicaid covers physical therapy for children with limitations. Thirty (30) visits per benefit year. PA required after visit limit is met. |
Ohio Medicaid covers physical therapy for adults with limitations. Thirty (30) visits per benefit year. PA required after visit limit is met. |
| Oklahoma | Oklahoma Medicaid covers physical therapy services for children, prior authorization is required after the initial evaluation. |
Oklahoma Medicaid only covers physical therapy for adults in an outpatient hospital setting with prior authorization. |
| Oregon |
Oregon Medicaid covers a total of thirty (30) visits per year of rehabilitative therapy and a total of thirty (30) visits per year of habilitative therapy (physical and occupational therapy) are included on these lines when medically appropriate. Additional visits, not to exceed thirty (30) visits per year of rehabilitative therapy and thirty (30) visits per year of habilitative therapy, may be authorized in cases of a new acute injury, surgery, or other significant change in functional status. Children under age 21 may have additional visits authorized beyond these limits if medically appropriate. |
Oregon Medicaid covers a total of thirty (30) visits per year of rehabilitative therapy and a total of thirty (30) visits per year of habilitative therapy (physical and occupational therapy) are included on these lines when medically appropriate. Additional visits, not to exceed thirty (30) visits per year of rehabilitative therapy and thirty (30) visits per year of habilitative therapy, may be authorized in cases of a new acute injury, surgery, or other significant change in functional status. |
| Pennsylvania | Pennsylvania Medicaid covers physical therapy services for children. |
Pennsylvania Medicaid covers physical therapy services for adults, may be limited to outpatient hospital setting. |
| Rhode Island | Rhode Island Medicaid covers physical therapy services for children. |
Rhode Island Medicaid covers physical therapy services for adults. |
| South Carolina |
South Carolina Medicaid covers physical therapy for children. Prior authorization is required when combined speech-language pathology, physical therapy and occupational therapy treatment services, delivered to beneficiaries under the age of 21 years or to waiver members, exceed the 420 of combined units (unit =15 minutes) per patient allowed per State Fiscal Year (SFY). |
South Carolina requires prior authorization for rehabilitative physical therapy treatment services delivered to beneficiaries aged 21 years and older. |
| South Dakota | South Dakota Medicaid covers physical therapy services for children. |
South Dakota Medicaid covers physical therapy services for adults. |
| Tennessee | Tennessee Medicaid coverage physical therapy as medically necessary for children, by a licensed PT, to restore, improve, stabilize or ameliorate impaired functions. |
Tennessee Medicaid covers physical therapy as medically necessary for adults, by a licensed PT, to restore, improve, or stabilize impaired functions. |
| Texas | Texas Medicaid covers physical therapy services for children for acute and chronic conditions with prior authorization |
Under Texas Medicaid, adult physical therapy services are limited to a maximum of 120 days per identified acute medical condition or acute exacerbation of a chronic medical condition requiring therapy or whenever the maximum benefit from therapy has been achieved, whichever comes first. |
| Utah |
Utah Medicaid covers physical therapy services for children are limited to twenty (20) therapy sessions, per member, per calendar year, when criteria are met. (The evaluation is not counted as one of the twenty (20) sessions.) Prior authorization is required for more than twenty (20) sessions per calendar year. Physical therapy services for maintenance are limited to EPSDT program eligible members and to one (1) PT and one (1) OT maintenance visit per month for care-giver training, to provide routine, repetitive or reinforced procedures of routine care in the residence. |
Utah Medicaid covers physical therapy services for adult members are limited to twenty (20) therapy sessions, per member, per calendar year, when criteria are met. (The evaluation is not counted as one of the twenty (20) sessions.) Prior authorization is required for more than twenty (20) sessions per calendar year. |
| Vermont |
Vermont Medicaid covers physical therapy services for children. Beginning January 1, 2025, no prior authorization will be required for outpatient PT, OT, and SLP services. |
Vermont Medicaid covers physical therapy services for adults. Beginning January 1, 2025, the number of outpatient PT, OT, and SLP visits allowed for adult members prior to needing prior authorization will be 60 combined PT, OT, and SLP outpatient visits per calendar year. These changes will include all members regardless of ACO attribution and regardless of medical condition. |
| Virginia |
Virginia Medicaid covers physical therapy services for children provided in outpatient settings of acute and rehabilitation hospitals, rehabilitation agencies, nursing facilities, or home health agencies shall include authorization for up to five (5) allowed visits, which do not require preceding service authorization, by each ordered rehabilitative service annually. Prior authorization is required after five (5) visits. |
Virginia Medicaid covers physical therapy services for adults provided in outpatient settings of acute and rehabilitation hospitals, rehabilitation agencies, nursing facilities, or home health agencies shall include authorization for up to five (5) allowed visits, which do not require preceding service authorization, by each ordered rehabilitative service annually. Prior authorization is required after five (5) visits. |
| Washington | Washington Medicaid provides clients age 18 and younger with an MCS benefit package have unlimited units for outpatient physical therapy rehabilitation benefits. |
Washington Medicaid provides short-term benefit limits for outpatient physical therapy for clients age 21 and older, and clients age 19 through 20 receiving MCS. These benefit limits are per client, per calendar year regardless of setting. Twenty-four (24) units (equals approximately six (6) hours). |
| West Virginia |
West Virginia Medicaid covers physical therapy services for children with limitations. Services are limited to a combined total of twenty (20) visits per event of physical therapy, occupational therapy, osteopathic manipulation, Chronic Pain Management programs, and chiropractic treatment. All services beyond the initial twenty (20) treatments require prior authorization. Initial evaluations are limited to one (1) per year. Reevaluations are limited to two per (2) year. |
West Virginia Medicaid covers physical therapy services for adults with limitations. Services are limited to a combined total of twenty (20) visits per event of physical therapy, occupational therapy, osteopathic manipulation, Chronic Pain Management programs, and chiropractic treatment. All services beyond the initial twenty (20) treatments require prior authorization. Initial evaluations are limited to one (1) per year. Reevaluations are limited to two per (2) year. |
| Wisconsin |
Wisconsin Medicaid covers physical therapy services for children. |
Wisconsin Medicaid covers physical therapy services for adults. Prior authorization is required for physical therapy services provided to an MA recipient in excess of thirty-five (35) treatment days per spell of illness. |
| Wyoming |
Wyoming Medicaid covers physical therapy services for adults. For dates of service in excess of twenty (20) per calendar year therapists will need to obtain prior authorization. Maintenance therapy can be provided for Members 20 and under. |
Wyoming Medicaid covers physical therapy services for adults. For dates of service in excess of twenty (20) per calendar year therapists will need to obtain prior authorization. Physical therapy services provided to Medicaid Members must be restorative for Members 21 and over. |