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Texas Medicaid Outpatient Physical, Occupational and Speech Therapy

Welcome to our Texas Medicaid page on outpatient physical and occupational therapy services.  The purpose of this page is to make the detailed coverage material more easily accessible and clearer for our members. 

Key Definitions

  • Physical Therapy
  • Occupational Therapy
  • Speech - Language Pathology
  • Acute Services
  • Chronic Services

    Providers and Settings

    • Eligible providers
    • Who can provide therapy services to children?
    • Who can provide therapy services to adults?
    • What are the criteria for providing therapy at the client’s home?
    • What is the role of assistants in providing therapy services?
    • Aides

      Children’s Services

      • Acute PT, OT, and ST Services
      • Chronic Services
      • Developmental Delay Criteria
      • Authorization Requirements for PT, OT, and ST Services
      • Requests for Recertification—Acute Therapy Services
      • Requests for Recertification - Chronic Therapy Services
      • PT, OT, and ST Therapy Procedure Codes

      Adult Services

        • Adult Physical and Occupational Services
        • Authorization Requirements for Outpatient and Home Health —PT, OT, and SLP Services
        • Requests for Recertification - Up to an Additional Sixty (60) days for Acute Services
        • PT, OT, and SLP Procedure Codes

      Frequency and Duration Criteria

      • High Frequency
      • Moderate Frequency
      • Low Frequency
      • Maintenance and Prevention

        Documentation

          • Written and Verbal Orders
          • Treatment Plan
          • Progress Summary
          • Treatment Note

        Co-Treatment

        • Group Therapy

        Services Not Covered


        Texas Medicaid Fee Schedules


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