SPECIAL BULLETIN COVID-19 #248: Telehealth Flexibilities for Occupational and Physical Therapies
EPSDT Prior Authorization Available July 1, 2022

EPSDT Prior Authorization Available July 1, 2022

Temporary Occupational Therapy (OT) and Physical Therapy (PT) telehealth flexibilities per SPECIAL BULLETIN COVID-19 #237 (which references SPECIAL BULLETIN COVID-19 #226 and SPECIAL BULLETIN COVID-19 #234) are scheduled to sunset on June 30, 2022 (previously set to expire March 31, 2022). All temporary policy flexibilities outlined in these bulletins remain in effect as of this publication date through June 30, 2022.

The State recognizes that there are unique circumstances for which telehealth delivery of OT and PT may be medically necessary. Beginning July 1, 2022, providers may request prior authorization (PA) for telehealth delivery of OT and PT services for Medicaid Direct beneficiaries ages 0-20 only as an EPSDT exception. EPSDT criteria can be found in NC Medicaid Clinical Coverage Policy 10A. Note: The EPSDT exception described applies only to beneficiaries enrolled in Medicaid Direct. For beneficiaries enrolled in a managed care plan, please refer to each applicable plan for guidance.

For details regarding the applicable OT and PT CPT codes that may be used for this telehealth exception, please see the PDF Document of SPECIAL BULLETIN COVID-19 #237 (pages 43-44). Here, you will also find information about:

  • flexibilities that have been or are being incorporated into permanent policy.
  • temporary flexibilities that will end on June 30, 2022.
  • temporary flexibilities that will end at the end of the federal PHE (date TBD).

For provider convenience, below are the applicable OT and PT CPT codes scheduled to sunset on June 30, 2022, which will be available beginning July 1, 2022, through this EPSDT PA review. Services provided by telehealth require a GT modifier on the claim.

OCCUPATIONAL THERAPY

Evaluation Codes

  • 97165    EVALUATION OF OCCUPATIONAL THERAPY, TYPICALLY 30 MINUTES
  • 97166    EVALUATION OF OCCUPATIONAL THERAPY, TYPICALLY 45 MINUTES
  • 97167    EVALUATION OF OCCUPATIONAL THERAPY ESTABLISHED PLAN OF CARE, TYPICALLY 60 MINUTES
  • 97168    RE-EVALUATION OF OCCUPATIONAL THERAPY ESTABLISHED PLAN OF CARE, TYPICALLY 30 MINUTES
  • 97750    PHYSICAL PERFORMANCE TEST OR MEASUREMENT WITH REPORT, EACH 15 MINUTES

Treatment Codes

  • 92065    EXERCISES TO CORRECT EYEBALL MUSCLE IMBALANCES
  • 92526    TREATMENT OF SWALLOWING AND/OR ORAL FEEDING FUNCTION (oral motor only)
  • 97110    THERAPEUTIC EXERCISE TO DEVELOP STRENGTH, ENDURANCE, RANGE OF MOTION, AND FLEXIBILITY, EACH 15 MINUTES
  • 97112    THERAPEUTIC PROCEDURE TO RE-EDUCATE BRAIN-TO-NERVE-TO-MUSCLE FUNCTION, EACH 15 MINUTES
  • 97116    WALKING TRAINING TO 1 OR MORE AREAS, EACH 15 MINUTES
  • 97530    THERAPEUTIC ACTIVITIES TO IMPROVE FUNCTION, WITH ONE-ON-ONE CONTACT BETWEEN PATIENT AND PROVIDER, EACH 15 MINUTES
  • 97533    SENSORY TECHNIQUE TO ENHANCE PROCESSING AND ADAPTATION TO ENVIRONMENTAL DEMANDS, EACH 15 MINUTES
  • 97535    SELF-CARE OR HOME MANAGEMENT TRAINING, EACH 15 MINUTES
  • 97542    WHEELCHAIR MANAGEMENT, EACH 15 MINUTES
  • 97763    ORTHOTIC(S)/PROSTHETIC(S) MANAGEMENT AND/OR TRAINING, UPPER EXTREMITY(IES), LOWER EXTREMITY(IES), AND/OR TRUNK, (SUBSEQUENT ORTHOTIC(S)/PROSTHETIC(S) ENCOUNTER, EACH 15 MINUTES)

PHYSICAL THERAPY

Evaluation Codes

  • 97161    PT EVAL 20 MIN
  • 97162    PT EVAL 30 MIN
  • 97163    PT EVAL 45 MIN
  • 97164    PT RE-EVAL
  • 97750    PHYSICAL PERFORMANCE TEST

Treatment Codes

  • 95992    CANALITH REPOSITIONING
  • 97110    THERAPEUTIC PROCEDURE (THERAPEUTIC EXERCISE TO DEVELOP STRENGTH AND ENDURANCE, RANGE OF MOTION AND FLEXIBILITY).
  • 97112    NEURO RE-EDUCATION (BALANCE, COORDINATION)
  • 97116    GAIT TRAINING (INCLUDES CLIMBING STAIRS)
  • 97530    THERAPEUTIC ACTIVITIES
  • 97533    SENSORY TECHNIQUE TO ENHANCE PROCESSING AND ADAPTATION TO ENVIRONMENTAL DEMANDS, EACH 15 MINUTES
  • 97535    SELF-CARE/ ADLS
  • 97542    WC MANAGEMENT
  • 97763    ORTHOTIC(S)/PROSTHETIC(S) MANAGEMENT AND/OR TRAINING, UPPER EXTREMITY(IES), LOWER EXTREMITY(IES), AND/OR TRUNK, (SUBSEQUENT ORTHOTIC(S)/PROSTHETIC(S) ENCOUNTER, EACH 15 MINUTES)

CONTACT

NCTracks Contact Center: 800-688-6696

 

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