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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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Florida Medicaid Coverage of Therapy Services

Florida Medicaid coverage and prior authorization information for therapy services.  See our Florida 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

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.

Occupational Therapy

All Florida Medicaid recipients who are 20 years of age or younger and not in a long-term care plan may receive occupational therapy services in accordance with the coverage and limitations policy.

All Florida Medicaid recipients who are 18 years of age or older who are in a Long-Term Care or Comprehensive Long-Term Care plan may receive occupational therapy.

Recipients 21 years of age and older may receive limited services pertaining to wheelchair evaluations and fittings.

OT services are otherwise not covered for adults.

Speech Therapy

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.

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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