048-26 Wyo. Code R. §§ 26-21 - Occupational Therapy Services

(a) Eligible providers. Licensed independent occupational therapists, hospitals, physicians, PRTFs, and developmental centers that employ licensed occupational therapists.

(b) Covered services.

(i) Prescribed rehabilitative occupational therapy services furnished in response to physical debilitation caused by acute physical trauma or physical illness;

(ii) Occupational therapy services prescribed while the client was an inpatient and continuing on an outpatient basis;

(iii) Occupational therapy services furnished in a developmental center or PRTF to a client pursuant to:

(A) An individualized education plan (IEP) developed by the school system or PRTF; or

(B) An individualized family services plan developed by a developmental center.

(c) Service limitations.

(i) Unless pre-approved, Medicaid reimbursement for client occupational therapy visits shall be limited to twenty (20) visits per calendar year.

(ii) Habilitative services are not covered for clients 21 years of age or older.

(iii) Except as otherwise specified in this Chapter, occupational therapy services shall be prescribed by the attending physician and re-certified by the attending physician every one hundred eighty (180) days.

Notes

048-26 Wyo. Code R. §§ 26-21

Amended, Eff. 12/17/2015. Amended, Eff. 4/9/2019. Amended, Eff. 5/7/2020. Amended, Eff. 5/13/2021.