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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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Moderate Frequency 

Therapy provided two times a week may be considered when documentation shows one or more of the following:

  • The patient is making very good functional progress toward goals.
  • The patient is in a critical period to gain new skills or restore function or is at risk of regression.
  • The licensed therapist needs to adjust the patient’s therapy plan and home program weekly or more often than weekly based on the patient’s progress and medical needs.
  • The patient has complex needs requiring ongoing education of the responsible adult.

    Citation

    Texas Medicaid Provider Manual

    Physical Therapy, Occupational Therapy, and Speech Therapy Services Handbook

    August 2019

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