Occupational Therapy (OT) services in Alabama are designed to help individuals improve their ability to perform tasks in living and working environments. These services are covered under Alabama Medicaid, particularly for children under 21 through the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program.
Service Description
Occupational Therapy services include:
- Evaluation of problems interfering with functional performance
- Implementation of therapy programs or purposeful activities that are rehabilitative, active, or restorative
These activities aim to:
- Improve, develop, or restore functions impaired or lost through illness, injury, or deprivation
- Enhance ability to perform tasks for independent functioning
- Prevent initial or further impairment or loss of function
- Correct or compensate for medical problems interfering with age-appropriate functional performance
Provider Qualifications
Occupational Therapists must:
- Be licensed by the Alabama State Board of Occupational Therapy
- Meet requirements in accordance with 42 CFR §440.110(b)
Occupational Therapy Assistants:
- May assist in practice only under OT supervision
- Must have an Associate of Arts degree
- Must be licensed by the Alabama State Board of Occupational Therapy
Supervision Requirements
- One-to-one on-site supervision of OT assistants at least every sixth visit
- Each supervisory visit must be documented and signed by the supervising OT
Billing and Reimbursement
- Local Education Agencies (LEAs) can bill for OT services provided in schools
- Reimbursement is based on the Alabama Medicaid Fee Schedule
- As of April 1, 2012, reimbursement for direct medical services is settled at cost for all LEAs
Additional Notes
- OT services must be documented in the student's Individualized Education Program (IEP)
- For adults aged 21 and older, OT services are generally not covered by Alabama Medicaid
- Detailed procedures and requirements for OT services to be billed through Alabama Medicaid are available
To get started, click the link to request portal access