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Elizabeth M. Whitehorn, Director

Provider Notice issued 05/07/13

Therapy Prior Approval Requests

To:​ Participating Physical, Occupational, and Speech Therapists, Hospitals, Home Health Agencies and Health Departments​
Date:​ May 7, 2013​
Re:​ Therapy Prior Approval Requests​

The purpose of this notice is to inform providers that prior approval requests for therapy services cannot cross fiscal years. The annual cap of 20 visits per discipline per year is calculated per Fiscal Year. Therefore, prior approval requests for Fiscal Year 2013 must have an end date that is no later than June 30, 2013. Prior approval requests for dates of service July 1, 2013 (Fiscal Year 2014) and later may be submitted on the same HFS 1409, but must be entered on a separate service line.

Please note, an end date of June 30, 2013 will be given to any prior approval request containing a single service line with a date range that crosses the fiscal year.

In addition, the department requests that the provider furnish both the department assigned provider number and the NPI when submitting prior approval requests.

Questions regarding this notice may be directed to the Bureau of Comprehensive Health Services at 1-877-782-5565.

Theresa A. Eagleson, Administrator

Division of Medical Programs