Update: PT/OT/ST Medicaid Service Authorization Processes

Date: 06/24/22

Heritage Health (Medicaid):

PT/OT/ST authorization processes for Medicaid services:

Effective July 1, 2022, the below processes to support administrative authorization will be retired. At that time our systems will be set up to enable the first 12 sessions, per discipline, for new episodes of care to be done without any administrative authorization.

For all Nebraska Total Care Medicaid members we will allow the first 12 sessions, per discipline, for a new episode of care to be administratively authorized to expedite services and allow for immediate access to care. There are no changes to our evaluation auth processes, and the evaluation remains a distinct service not included in these 12 initial sessions. Evaluations continue to be able to be billed on the same day as services.

 

If you have questions, please contact Provider Relations.