Therapy Services

HOW TO ACCESS:

Recipients have the choice of services from the following provider types: Home Health; Hospital-Outpatient Services; and Rehabilitation Clinic Services.

ELIGIBILITY:

Medicaid recipients 0 through 20 years of age.

COVERED SERVICES:

  • Audiological Services (Available in Rehabilitation Clinic and Hospital-Outpatient settings only.)
  • Occupational Therapy
  • Physical Therapy
  • Speech & Language Therapy


COMMENTS:

Covered services can be provided in the home through Home Health and Rehabilitation Clinics. Services provided by Rehabilitation Clinics can also be provided at the clinic. Services provided through Hospital-Outpatient Services must be provided at the facility/clinic.

Covered services may be provided in addition to services provided by EarlySteps/EICs or School Boards if prescribed by a physician and Prior Authorized.

All medically necessary services must be prescribed by a physician and Prior Authorization is required. The provider of services will submit requests for Prior Authorization.


CONTACT:

For therapies provided in a hospital setting:

Sharetha Brown
225/219-2555

For therapies provided via the home health program or rehabilitation clinics:

Justing Owens

225/342-6888 

 

HOW TO ACCESS:

EPSDT Health Services-Early Intervention Centers (EIC) or EarlySteps Program

ELIGIBILITY:

Medicaid recipients under 3 years of age.

COVERED SERVICES:

  • Audiological Services
  • Occupational Therapy
  • Physical Therapy
  • Speech & Language Therapy
  • Psychological Therapy


COMMENTS:

All EPSDT Health Services through EICs amd EarlySteps must be included in the infant/toddler's Individualized Family Service Plan (IFSP). If services are provided by an EIC or EarlySteps, Prior Authorization requirements are met through inclusion of services on the IFSP.

CONTACT:

Caroline Nailor-Oglesby
225/342-0095


HOW TO ACCESS:

EPSDT Health Services-Local Education Agencies (LEA) e.g. School Boards

ELIGIBILITY:

Medicaid recipients 3 through 20 years of age.

COVERED SERVICES:

  • Behavioral Health Services
  • Applied Behavior Analyst Therapy (ABA)
  • Occupational, Physical, Speech and Respiratory Therapy
  • Optometry Services
  • Personal Care Services (PCS)
  • Physician/Nursing Services
  • Transportation

 
COMMENTS:

  • Services are performed by the Local Education Agencies (LEA).
  • EPSDT health services on the Medicaid approved Periodicity Table may be reimbursed when provided by a licensed practitioner within the scope of their practice. All other health services must be included in a completed authorizing document pursuant to 34 C.F.R. § 104.36:
    • Individualized Education Plan (lEP);
    • Section 504 Accommodation Plan;
    • Individualized Health Care Plan; or
    • Any other medically necessary written plan of care.


CONTACT:

Anissa Young-Ned
225/342-6885