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Helpful Tips for Providers
When billing for therapy, be aware of when modifiers need to be added to the billing code to bill correctly for services.
OCCUPATIONAL THERAPY
- 97003 - Evaluation for Occupational Therapy
- 97530 - Individual Occupational Therapy
- 97530 UB - Individual Occupational Therapy by Occupational Therapy Assistant
- 97150 U2 - Group Occupational Therapy
- 97150 UB, U1 - Group Occupational Therapy by Occupational Therapy Assistant
PHYSICAL THERAPY
- 97001 - Evaluation for Physical Therapy
- 97110 - Individual Physical Therapy
- 97150 - Group Physical Therapy
- 97110 UB - Individual Physical Therapy by Physical Therapy Assistant
- 97150 UB - Group Physical Therapy by Physical Therapy Assistant
SPEECH THERAPY
- 92506 - Evaluation for Speech Therapy
- 92507 - Individual Speech Therapy
- 92508 - Group Speech Therapy
- 92507 UB - Individual Speech Therapy by Speech-Language Pathology Assistant
- 92508 UB - Group Speech Therapy by Speech-Language Pathology Assistant
Section 262.100 Arkansas Medicaid Provider Manual
Sound errors must be documented for all articulation tests performed in evaluations.
"Results from an assessment specific to the suspected type of speech production disorder, including all relevant scores, quotients and/or indexes, if applicable. All errors specific to the type of speech production disorder must be reported (e.g., positions, processes, motor patterns). "
Section II-214.400 C3e Arkansas Medicaid Provider Manual
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Q & A about Medicaid
Que stion: What is the eligibility criteria for Apraxia?
Two tests and/or procedures must be administered with at least one being a norm-referenced, standardized test with good reliability and validity. Eligibility for apraxia therapy will be based upon standard scores (SS) of -1.5 SD or greater below the mean from two tests.
When -1.5 SD or greater is not indicated by both of these tests, corroborating data from a criterion-referenced test and/or accepted procedures can be used to support the medical necessity of services (Review Section 214.410 - Accepted Tests for Speech-Language Therapy).
Section II-214.400 D3 Arkansas Medicaid Provider Manual
Question: How do I update my provider demographic information with Medicaid?
You can submit the update change online on the provider page of the Arkansas Medicaid Web site or contact Provider Assistance at 1-800-457-4454.
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