Therapy Comply - Medicaid Coverage of Speech Therapy in all 50 States

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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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50 State Surveys
Medicaid Coverage of Speech Therapy in all 50 States

Medicaid Coverage of Speech Therapy Services

Below is the basic Medicaid coverage information for speech therapy services for children and adults. 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.

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Zachary Edgar JD, LLM is the managing partner for Therapy Comply. Zachary is a healthcare attorney that specializes in federal and state healthcare regulatory issues particularly for physical, occupational, and speech therapy practices.

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State	Children	Adults
Alabama	Alabama Medicaid covers speech therapy for children without prior authorization.	Alabama Medicaid does not cover speech therapy for adults.
Alaska	Alaska Medicaid covers speech therapy for children when medically necessary and ordered by a physician, advanced nurse practitioner, or other licensed health care practitioner. Services include screening, evaluation, and treatment of defects and disorders of the voice and spoken/written communication.	Alaska Medicaid covers speech therapy for both adults when medically necessary and ordered by a physician, advanced nurse practitioner, or other licensed health care practitioner. Services include screening, evaluation, and treatment of defects and disorders of the voice and spoken/written communication.
Arizona	Arizona Medicaid covers speech therapy for members under the age of 21 and ALTCS members.	Arizona Medicaid covers SLP services provided to all members who are receiving inpatient care at a hospital, nursing facility or custodial care facility when services are ordered by the member's PCP or attending physician. Outpatient speech therapy is not covered for adults.
Arkansas	Arkansas Medicaid and ARKids First-A will pay for speech therapy for patients who are younger than 21.	Arkansas Medicaid does not cover outpatient speech therapy for adults.
California	California Medicaid or Medi-Cal covers speech therapy for children with prior approval.	California Medicaid or Medi-Cal covers speech therapy for adults with prior approval. Limited to two (2) visits a month.
Colorado	Colorado Medicaid covers speech therapy services for children. Children may qualify for rehabilitative and habilitative therapy.	Colorado Medicaid limits speech therapy for adults to rehabilitative therapy only. Some adults qualify for habilitative therapy.
Connecticut	Connecticut Medicaid covers Speech therapy services for children. Prior authorization is needed for more than two (2) visits per week.	Connecticut Medicaid covers Speech therapy services for adults. Prior authorization is needed for more than two (2) visits per week.
Delaware	Delaware Medicaid covers speech therapy services for children.	Delaware Medicaid covers speech 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 speech-language pathology 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 speech-language pathology services. Recipients 21 years of age and older may receive limited speech-language pathology services pertaining to provision of augmentative and alternative communication systems.
Georgia	Georgia Medicaid covers speech therapy for children. Prior authorization after 8 units per month.	Georgia Medicaid only covers adult speech therapy services, in a hospital setting, immediately following and in treatment of acute illness, injury or impairment.
Hawaii	Hawaii Medicaid covers speech therapy for children with prior authorization.	Hawaii Medicaid covers speech therapy for adults with prior authorization.
Idaho	Idaho Medicaid covers speech therapy for children.	Idaho Medicaid covers speech therapy for adults.
Illinois	Illinois Medicaid covers speech therapy for children with prior approval.	Illinois Medicaid covers speech therapy for adults with prior approval.
Indiana	Indiana Medicaid covers rehabilitative speech therapy services for members under 21 years of age when determined medically necessary. Indiana Medicaid covers habilitative speech 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, the IHCP covers rehabilitative speech 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 speech therapy for children.	Iowa Medicaid covered speech therapy for adults.
Kansas	Kansas Medicaid covers developmental speech/language therapy services are covered for children under 21 years of age. Habilitative therapy is covered only for participants zero to under 21 years of age.	Kansas Medicaid covers speech 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 consecutive months per injury or illness for participants 21 years of age and older.
Kentucky	Kentucky Medicaid covers speech therapy for children up to twenty (20) visits a year, prior authorization for additional visits.	Kentucky Medicaid covers speech 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 speech therapy for adults in outpatient hospital settings, with prior authorization.
Maine	Maine covers speech therapy services for children.	Maine Medicaid covers speech therapy for adults with limitations, prior authorization is required.
Maryland	Maryland Medicaid covers speech therapy services for children. Providers of speech therapy services should bill FFS Medicaid for participants under 21 years of age.	Maryland Medicaid covers speech 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 speech therapy for children with prior authorization.	The MassHealth agency requires that the speech therapist obtain prior authorization as a prerequisite to payment for the following services to eligible MassHealth members: More than thirty-five (35) speech/language therapy visits, including group-therapy visits but not including evaluations, for a member in a twelve (12) month period; More than two (2) evaluations in a twelve (12) month period.
Michigan	Michigan Medicaid covers speech therapy for children. Outpatient: Up to 36 visits of ST per calendar year period. Nursing Facility: ST performed within 60 days of the beneficiary’s admission to the facility. Home Health ST is covered for CSHCS beneficiaries only. Prior authorization is required after the limits are reached.	Michigan Medicaid covers speech therapy for adults. Outpatient: Up to 36 visits of ST per calendar year period. Nursing Facility: ST performed within 60 days of the beneficiary’s admission to the facility. Home Health ST is covered for CSHCS beneficiaries only. Prior authorization is required after the limits are reached.
Minnesota	Minnesota Medicaid covers speech therapy for children without prior authorization. Specialized maintenance therapy coverage is limited to MHCP members aged 20 and younger.	Minnesota Medicaid covers speech therapy for adults without prior authorization.
Mississippi	Mississippi Medicaid covers speech therapy for children with prior authorization.	Mississippi Medicaid covers speech therapy for adults with prior authorization.
Missouri	Missouri Medicaid covered speech therapy services for children.	Missouri Medicaid has limited speech 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 speech therapy for children.	Montana Medicaid covers speech 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 speech therapy for children. Prior authorization is required except for the initial evaluation and re-evaluations.	Nevada Medicaid covers speech therapy for adults. Prior authorization is required except for the initial evaluation and re-evaluations.
New Hampshire	New Hampshire Medicaid covers speech therapy services for children with limitations. Services for speech, hearing and language disorders shall be limited to 80 fifteen-minute units per member per state fiscal year (July 1 – June 30). The 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 speech therapy services for adults with limitations. Services for speech, hearing and language disorders shall be limited to 80 fifteen-minute units per member per state fiscal year (July 1 – June 30). The 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 speech therapy for children when provided by speech therapists employed in a physician’s office.	New Jersey Medicaid covers speech therapy for adults when provided by speech therapists employed in a physician’s office. Outpatient rehabilitation benefits are limited to treatment over a period of 60 consecutive business days per incident of illness or injury beginning with the first day of treatment.
New Mexico	New Mexico Medicaid covers speech therapy for children with prior approval.	New Mexico Medicaid covers speech therapy for adults with prior approval.
New York	New York Medicaid covers speech therapy services for children.	New York Medicaid covers speech therapy services for children.
North Carolina	North Carolina Medicaid covers speech therapy services for children with prior authorization.	North Carolina Medicaid covers speech therapy services for adults with limitations. A total maximum of thirty (30) treatment visits per calendar year for speech therapy habilitative services. A total maximum of thirty (30) treatment visits per calendar year for speech therapy rehabilitative services.
North Dakota	North Dakota covers speech therapy for children. Speech therapy evaluations are limited to one (1) per calendar year.	North Dakota covers speech therapy for adults with limitations. Speech therapy evaluations are limited to one (1) per calendar year. speech 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 speech therapy for children with limitations. Thirty (30) visits per benefit year. PA required after visit limit is met.	Ohio Medicaid covers speech therapy for adults with limitations. Thirty (30) visits per benefit year. PA required after visit limit is met.
Oklahoma	Oklahoma Medicaid covers speech therapy services for children, prior authorization is required before the initial evaluation.	Oklahoma Medicaid only covers speech 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 (speech therapy) are included 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 necessary and 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 (speech therapy) are included 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 speech therapy services for children.	Pennsylvania Medicaid covers speech therapy services for adults, may be limited to outpatient hospital setting.
Rhode Island	Rhode Island Medicaid covers speech therapy services for children.	Rhode Island Medicaid covers speech therapy services for adults.
South Carolina	South Carolina Medicaid covers speech 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 speech therapy treatment services delivered to beneficiaries aged 21 years and older.
South Dakota	South Dakota Medicaid covers speech therapy services for children.	South Dakota Medicaid covers speech therapy services for adults.
Tennessee	Tennessee Medicaid coverage speech therapy as medically necessary for children, by a licensed SLP, to restore, improve, stabilize or ameliorate impaired functions.	Tennessee Medicaid covers speech therapy as medically necessary or adults, as long as there is continued medical progress, by a licensed SLP to restore speech after a loss or impairment.
Texas	Texas Medicaid covers speech therapy services for children for acute and chronic conditions with prior authorization.	Under Texas Medicaid, adult speech 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 speech therapy services for children, limited to a combined total of twenty-four (24) sessions in a six (6) month period. Prior authorization is required after limits have been reached.	Utah Medicaid covers speech therapy for adults with limits depending on the condition. Pregnant Members: Fifteen (15) annual visits. Speech therapy for cognitive purposes is limited to fifteen (15) visits per twelve (12) month period. Speech therapy for the use of a speech generating device is limited to eight (8) visits per twelve (12) month period. Treatment for swallowing dysfunction and/or oral function is limited to ten (10) per 180-day period.
Vermont	Vermont Medicaid covers speech therapy services for children. Beginning January 1, 2025, no prior authorization will be required for outpatient PT, OT, and SLP services.	Vermont Medicaid covers speech 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 speech 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 speech 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 speech therapy rehabilitation benefits.	Washington Medicaid provides short-term benefit limits for outpatient speech 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. Six (6) units (equals a total of six (6) untimed visits).
West Virginia	West Virginia Medicaid covers speech-language therapy services are covered for Medicaid members up to 21 years of age.	For West Virginia members 21 years of age and older, speech-language therapy is limited to one evaluation for medical/surgical conditions which include, but are not limited to: cerebral vascular accident (CVA), tracheotomy, tracheostomy, laryngectomy, traumatic brain injury (TBI), nerve injuries (e.g., 5th, 7th – 12th), amyotrophic lateral sclerosis (ALS), cerebral palsy, and dysarthria. Speech language therapy requires prior authorization beyond the initial evaluation.
Wisconsin	Wisconsin Medicaid covers speech therapy services for children. Prior authorization is required for speech and language pathology services provided to an MA recipient in excess of thirty-five (35) treatment days per spell of illness.	Wisconsin Medicaid covers speech therapy services for adults. Prior authorization is required for speech and language pathology services provided to an MA recipient in excess of thirty-five (35) treatment days per spell of illness.
Wyoming	Wyoming Medicaid covers speech therapy services for children. For dates of service in excess of thirty (30) per calendar year therapists will need to obtain prior authorization. Maintenance therapy can be provided for Members 20 and under.	Wyoming Medicaid covers speech therapy services for adults. For dates of service in excess of thirty (30) per calendar year therapists will need to obtain prior authorization. Speech therapy services provided to Medicaid Members must be restorative for Members 21 and over.