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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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Michigan Medicaid Coverage of Therapy Services

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

Michigan Medicaid covers physical therapy for children.

Outpatient: Up to 144 units of PT per calendar year period.

Nursing Facility: PT performed within 60 days of the beneficiary’s admission to the facility.

Home Health: Up to 24 visits of PT in one 60 consecutive day period.

Prior authorization is required after the limits are reached.

Michigan Medicaid covers physical therapy for adults.

Outpatient: Up to 144 units of PT per calendar year period.

Nursing Facility: PT performed within 60 days of the beneficiary’s admission to the facility.

Home Health: Up to 24 visits of PT in one 60 consecutive day period.

Prior authorization is required after the limits are reached.

Occupational Therapy

Michigan Medicaid covers occupational therapy for children.

Outpatient: Up to 144 units of OT per calendar year period.

Nursing Facility: OT performed within 60 days of the beneficiary’s admission to the facility.

Home Health: Up to 24 visits of OT in one 60 consecutive day period.

Prior authorization is required after the limits are reached.

Michigan Medicaid covers occupational therapy for adults.

Outpatient: Up to 144 units of OT per calendar year period.

Nursing Facility: OT performed within 60 days of the beneficiary’s admission to the facility.

Home Health: Up to 24 visits of OT in one 60 consecutive day period.

Prior authorization is required after the limits are reached.

Speech Therapy

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.

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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