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Indiana Medicaid Occupational Therapy Services

Order

For IHCP reimbursement, occupational therapy services must be ordered by a physician or (effective February 1, 2017) by one of the following providers:

    • Chiropractor
    • Nurse practitioner
    • Optometrist
    • Physician assistant
    • Podiatrist
    • Psychologist

Eligible Providers

Occupational therapy services must be performed by a licensed occupational therapist or a licensed occupational therapy assistant under the direct, on-site supervision of a licensed occupational therapist. A licensed occupational therapist must perform an evaluation for IHCP reimbursement to be made.

Evaluations and Reevaluations

The IHCP limits evaluations and reevaluations to three (3) hours of service per evaluation. The

Services Not Covered

IHCP does not cover the following occupational therapy services:

    • General strengthening exercise programs for recuperative purposes
    • Passive range-of-motion services as the only or primary mode of therapy
    • Occupational therapy psychiatric services

The IHCP does not reimburse separately for occupational therapy services provided by a nursing facility or a large private or small ICF/IID. These services are included in the facility’s established per diem rate and do not require PA.

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