Upcoming Webinars 


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.

Log in

Log in

Texas Medicaid Outpatient Therapy

Welcome to our Texas Medicaid page on outpatient physical, occupational, and speech 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


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


        • Co-Treatment
        • Group Therapy

        Services Not Covered

        Powered by Wild Apricot Membership Software