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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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Arizona Medicaid Covered Therapy Services

Arizona Medicaid coverage information for therapy services.  See our Arizona Medicaid Outpatient Therapy page for more detailed information.  Members can email us with any questions about Medicaid coverage or compliance questions. 

Children

Adults

Physical Therapy

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:

  • Fifteen (15) PT visits per benefit year for the purpose of restoring a skill or level of function and maintaining that skill or level of function once restored, and
  • Fifteen (15) PT visits per benefit year for the purpose of acquiring a new skill or a new level of function and maintaining that level of function once acquired.

Occupational Therapy

Arizona Medicaid covers outpatient occupational therapy services are covered for ALTCS members and members under the age of 21.

Arizona Medicaid covers occupational therapy services provided to all members who are receiving inpatient care at a hospital, nursing facility, and custodial care facility when services are ordered by the member’s PCP/attending physician.

Outpatient OT services are covered for Acute members, 21 years of age and older as follows:

  • Fifteen (15) OT visits per benefit year for the purpose of restoring a skill or level of function and maintaining that skill or level of function once restored, and
  • Fifteen (15) OT visits per benefit year for the purpose of acquiring a new skill or a new level of function and maintaining that skill or level of function once acquired.

Speech Therapy

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.


About Us

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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