Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.07-014 - Developmental Day Treatment Clinic Services Provider Manual Update # 92

201.200 DDTCS Providing Occupational, Physical, or Speech Therapy

Optional services available through DDTCS include occupational, physical and speech therapy and evaluation as an essential component of the plan of care for an individual accepted for developmental disabilities services. Therapy services are not included in the core services and are provided in addition to the core services (see section 214.210 and 215.200, of this manual, for additional requirements for provision of therapy services).

If a DDTCS provider contracts with an individual qualified therapist or speech-language pathologist, the criteria for group providers of therapy services apply (See section 201.100 of the Occupational, Physical, Speech Therapy Services manual). The qualified individual is considered the provider of therapy services and must complete an application and contract with the Division of Medical Services. The individual provider will not bill Arkansas Medicaid for services as they are contracted through the DDTCS Provider, however Medicaid participation will be indicated by the provider identification number indicated as a performing provider when the facility bills for services.

Therapists directly employed by a facility will not bill Arkansas Medicaid for services nor indicate their individual Medicaid provider identification number for services provided as an employee of the billing facility. Therefore, the individual therapist's Medicaid participation will appear inactive to the Medicaid enrollment system. EDS will annually notify all providers, at the address currently on file with Arkansas Medicaid for the individual's enrollment, that no activity with the Medicaid program for the calendar year will inactivate their individual provider participation. It will be necessary for each individual therapy provider-employee to complete and return form DMS-0663 (V iew or print form DMS-0663) on an annual basis to have their enrollment remain active and not purged due to inactivity. All forms are located in Section V of each manual.

220.110 Accepted Tests for Occupational Therapy

Tests used must be norm referenced, standardized, age appropriate and specific to the therapy provided. The following list of tests is not all-inclusive. When using a test not listed here, the provider must include additional documentation to support the reliability and validity of the test. This additional information will be used as reference information if the chart is ever selected by Medicaid for review. An explanation of why a test from the approved list could not be used to evaluate the child must also be included. The Mental Measurement Yearbook (MMY) is the standard reference to determine the reliability and validity of the test(s) administered in an evaluation. Providers should refer to the MMY for additional information regarding specific tests.

Definitions:

STANDARD: Evaluations that are used to determine deficits.

SUPPLEMENTAL: Evaluations that are used to justify deficits and support other results. These should not "stand alone."

CLINICAL OBSERVATIONS: All clinical observations are supplemental but should be included with every evaluation, especially if standard scores do not qualify the child for therapy. They will be considered during reviews for medical necessity.