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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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California Medicaid Outpatient Therapy Guidelines

28 Jan 2022 10:17 AM | Zachary Edgar (Administrator)

Guidelines for California's Medicaid coverage of physical, occupational and speech therapy services.  Including coverage, limitations, prescription requirements, prior authorization and documentation.  If the client is enrolled in a managed care plan some of the rules may be different.  If you need additional assistance please email us at info@therapycomply.com.

Physical Therapy

  • Eligible Providers
  • Prescription Requirements
  • Covered Services
  • Prior Authorization
  • Claim Information

PT Codes and Rates

Speech Therapy

  • Eligible Providers
  • Coverage
  • Written Referral Requirements
  • Initial and Six-Month Evaluations
  • Required Professional Experience Services

SLP Codes and Rates

Occupational Therapy

  • Eligible Providers
  • Limitations
  • Prescription Requirement
  • Initial and Six-Month Evaluations
  • Claims

OT Codes and Rates


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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