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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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Indiana Medicaid Coverage of Therapy Services

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

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.

Occupational Therapy

Indiana Medicaid covers rehabilitative occupational therapy services for members under 21 years of age when determined medically necessary.

Indiana Medicaid covers habilitative occupational 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 occupational 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.

Speech Therapy

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.

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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