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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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Missouri Medicaid Coverage of Therapy Services

Missouri Medicaid coverage and prior authorization information for therapy services.  See our Missouri Medicaid Outpatient Therapy page for more detailed information.  Members can email me with any questions or schedule a call about any Medicaid coverage, billing or compliance issues.  

Children

Adults

Physical Therapy

Missouri Medicaid covered physical therapy services for children.

Missouri Medicaid has limited physical therapy coverage for adults.

Habilitative Services:

The combination of all   habilitative skilled therapy services for the adult expansion group is limited to a total of 20 visits per rolling year, inclusive of services from all MHD providers.

Participants 19 to 20 years old in the adult expansion group may receive all medically necessary habilitative skilled therapy services.  Prior authorization is not required.

Occupational Therapy

Missouri Medicaid covered occupational therapy services for children.

Missouri Medicaid has limited occupational therapy coverage for adults.

Habilitative Services:

The combination of all   habilitative skilled therapy services for the adult expansion group is limited to a total of 20 visits per rolling year, inclusive of services from all MHD providers.

Participants 19 to 20 years old in the adult expansion group may receive all medically necessary habilitative skilled therapy services.  Prior authorization is not required.

Speech Therapy

Missouri Medicaid covered speech therapy services for children.

Missouri Medicaid has limited speech therapy coverage for adults.

Habilitative Services:

The combination of all   habilitative skilled therapy services for the adult expansion group is limited to a total of 20 visits per rolling year, inclusive of services from all MHD providers.

Participants 19 to 20 years old in the adult expansion group may receive all medically necessary habilitative skilled therapy services.  Prior authorization is not required.

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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