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Provider Notice issued 10/23/15
Chapter H-200, Handbook for Providers of Hospital Services Prior Approval Requirements for Physical and Occupational Therapy Services for Children through Age 20 Effective November 16, 2015
| To: | Enrolled Hospitals: Chief Executive Officers; Chief Financial Officers; Patient Accounts Managers; and Health Information Management Directors |
| Date: | October 23, 2015 |
| Re: | Chapter H-200, Handbook for Providers of Hospital Services Prior Approval Requirements for Physical and Occupational Therapy Services for Children through Age 20 Effective November 16, 2015 |
As a result of Public Act 098-0651(pdf), the Department is required to prior approve all adult and children’s therapy services for medical necessity. The Department is now implementing prior approval for medical necessity of physical and occupational therapy for children through age 20, effective with dates of service beginning November 16, 2015. Speech therapy prior approval for children will be put into effect at a later date.
Topic H-270.3 has been revised to reflect the prior approval requirement for children. As these services are billed as fee-for-service, hospitals should refer to the Therapy Releases page and the Handbook for Providers of Therapy Services for specific prior approval and billing instructions.
Instructions for updating the Handbook for Providers of Hospital Services:
Topic H-270.3
Remove pages HFS 270.3 (3-4) and (5-6) and insert new pages HFS 270.3 (3-4) and (5-6).