Big news for Missouri special education professionals! Exciting developments are underway as the state of Missouri has taken a significant step forward to align with the rest of the nation. Now, COTA’s, PTA’s, and SLP-A’s are eligible to enroll as Medicaid providers, allowing them to bill for covered therapy services provided to eligible Medicaid participants.
Key points to consider:
- Legislation Milestone: Effective November 1, 2023, the MO HealthNet Division (MHD) officially permits therapy assistants to enroll as Medicaid providers and bill for covered therapy services.
- How to Enroll: To take advantage of this opportunity, Therapy Assistant Providers must complete the online Provider Enrollment Application. When enrolling, select the appropriate provider type: 46 for Speech/Language Therapy, 47 for Occupational Therapy, or 48 for Physical Therapy.
- Licensing and Supervision: Therapy assistant providers must be licensed and supervised. Proof of supervision is required during the enrollment process.
- Enrollment Effective Date: The Provider Enrollment Unit, a division of Missouri Medicaid Audit and Compliance (MMAC), will enroll each therapy assistant in the system with an effective date of November 1, 2023, or later.
- Many districts use a third-party billing service like Therapylog or Claimcare. These agencies can help with therapist enrollment.
Next Steps for Therapist Assistants:
- Obtain NPI Number: All therapist assistants need to obtain a National Provider Identifier (NPI) number and submit it to their Medicaid Intermediary.
- Wait for Medicaid Number: After submitting the NPI, therapist assistants will need to wait for a Medicaid number to be issued. While they are waiting, they should keep documentation as if they were already billing Medicaid because, in most cases, a therapist will be able to backdate their billing for services provided since November 1, 2023.
- Update Documentation System: For reimbursement purposes, therapists must update their documentation. Parents’ permission is essential, and assistants need to document the time spent with students, the activity worked on, and whether it was conducted individually or in a group.
- Diagnosis Code Required: Obtain a diagnosis code for the therapy services provided.
For further details and to access the full text of the new law or bill, please visit this link.
This groundbreaking development opens new avenues for therapy assistants to support special education students while streamlining the billing process. Stay informed, take the necessary steps, and be part of this positive change in Missouri’s special education landscape!
