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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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Site Updates

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  • Updates to North Carolina Medicaid

    18 Sep 2018 2:54 PM | Zachary Edgar (Administrator)

    Prior Approval changes to NC Medicaid coverage for adults.

    Removal of diagnosis specific coverage and replaced with general prior authorization requirement and service limit:

    Prior approval is required at the start of all treatment services. 

    Detailed information and instructions for registering and submitting requests is available on The Carolinas Center of Medical Excellence (CCME) website https://www.medicaidprograms.org/NC/ChoicePA The provider shall submit a request to DHHS utilization review contractor to start the approval process. Please note that approval, if granted, is for medical approval only and does not guarantee payment or ensure beneficiary eligibility on the date of service. 

    The first prior approval request within a calendar year shall be for no more than three therapy treatment visits and one month. The PA review vendor will authorize these three treatment visits to begin as early as the day following the submission of the PA request. Any subsequent PA may be obtained for up to 12 therapy treatment visits and six months. A beneficiary can receive a maximum of 27 therapy treatment visits per calendar year across all therapy disciplines combined (occupational therapy, physical therapy and speech/language therapy). 

    Each reauthorization request must document the efficacy of treatment.


  • Massachusetts Physical Therapy

    20 Aug 2018 4:08 PM | Zachary Edgar (Administrator)

    Content added:

    Massachusetts Medicaid Coverage of Physical and Occupational Therapy 

    MA PT Scope of Practice

    MA PT Direct Access and Referrals

    MA PT Supervision and Delegation

    MA PT Assistants

    MA PT Aides

    MA PT Students

    MA PT Temporary Permits

    MA PT License Exemptions

    MA PT Licensure by Endorsement

    MA PT License Reinstatement 

    MA PT Documentation 

    MA PT Identification and Notifications

    MA PT Facilities 

    MA PT Board Fees

    Mass Medicaid and Workers Comp Fee Schedules 


  • Florida OT Updates

    14 Aug 2018 4:09 PM | Zachary Edgar (Administrator)


  • California Physical Therapy

    13 Aug 2018 3:09 PM | Zachary Edgar (Administrator)

    Content added 8/13/2018

    California Medicaid Coverage of PT and OT

    CA PT Continuing Education

    CA PT Scope of Practice

    CA PT Electromyography

    CA PT Topical Medications

    CA PT Direct Access and Referrals 

    CA PT Assistants

    CA PT Aides

    CA PT Students

    CA PT and PTA Graduates 

    CA PT Documentation 

    CA PT Advertising

    CA PT Unprofessional Conduct

    CA PT Board Fees

    CA Fee Schedules



  • Alabama Updates

    13 Aug 2018 2:17 PM | Zachary Edgar (Administrator)

    Added additional content to both Alabama physical and occupational therapy sections along with Alabama's Medicaid coverage of PT and OT. 

  • Welcome to Therapy Comply

    14 Nov 2017 11:32 AM | Zachary Edgar (Administrator)

    We are celebrating the launch of Therapy Comply this week.  This site's goal is to provide physical and occupational therapists with key state and federal regulatory information.  This will include detailed surveys on state law, for example: PTA/Aide supervision, scope of practice, continuing education requirements, direct access, disciplinary information, license provisions, and more.  The site will also include guides on Medicaid, Medicare, Tricare, and workers' compensation.  We hope the site will serve your compliance needs and improve your ability to provide care to your patients.  

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About Me

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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