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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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Washington Medicaid Coverage of Therapy Services

Washington Medicaid coverage and prior authorization information for therapy services.  See our Washington Medicaid Outpatient Therapy page for more detailed information.  Members can email me with any questions or schedule a call about any Medicaid coverage, billing or compliance issues.  

Children

Adults

Physical Therapy

Washington Medicaid provides clients age 18 and younger with an MCS benefit package have unlimited units for outpatient physical therapy rehabilitation benefits.

Washington Medicaid provides short-term benefit limits for outpatient physical therapy for clients age 21 and older, and clients age 19 through 20 receiving MCS. These benefit limits are per client, per calendar year regardless of setting.

Twenty-four (24) units (equals approximately six (6) hours).

Occupational Therapy

Washington Medicaid provides clients age 18 and younger with an MCS benefit package have unlimited units for outpatient occupational therapy rehabilitation benefits.

Washington Medicaid provides short-term benefit limits for outpatient occupational therapy for clients age 21 and older, and clients age 19 through 20 receiving MCS. These benefit limits are per client, per calendar year regardless of setting.

Twenty-four (24) units (equals approximately 6 hours) to treat physical conditions.

Twenty-four (24) units (equals approximately six (6) hours) to treat behavioral health conditions.

Speech Therapy

Washington Medicaid provides clients age 18 and younger with an MCS benefit package have unlimited units for outpatient speech therapy rehabilitation benefits.

Washington Medicaid provides short-term benefit limits for outpatient speech therapy for clients age 21 and older, and clients age 19 through 20 receiving MCS. These benefit limits are per client, per calendar year regardless of setting.

Six (6) units (equals a total of six (6) untimed visits).

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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