Current through Register 1531, September 27, 2024
Payment for the services described in 130 CMR 432.000 will be
made only to therapists who are participating in MassHealth on the date of
service, for services personally rendered by therapists or for services
rendered by licensed therapy assistants, subject to the supervision
requirements of 130 CMR 432.404(D). To participate in MassHealth as an in-state
MassHealth provider, the provider must:
(A) obtain a MassHealth Provider number
before providing therapy services;
(B) notify the MassHealth agency in writing
within 14 days of any change in any of the information submitted in the
provider application in accordance with
130 CMR
450.223(B): Provider
Contract: Execution of Contract including, but not limited to, change
of ownership, change of address, and addition or deletion of a branch
office;
(C) meet all applicable
state and federal regulatory requirements including, but not limited to, 101
CMR 339.00: Restorative Services, 130 CMR 432.000, and 130
CMR
(D) meet the applicable
requirements below.
(1)
Physical
Therapist. A physical therapist must be currently licensed by and
in good standing with the Massachusetts Division of Professional Licensure,
Board of Allied Health Professionals as a physical therapist.
(2)
Physical Therapist Assistant
(PTA). A PTA must be currently licensed by and in good standing
with the Massachusetts Division of Professional Licensure, Board of Allied
Health Professionals as a PTA. PTAs must work under the supervision of a
licensed physical therapist. Supervision of PTAs must be performed following
state regulatory guidance. For physical therapy, see 259 CMR
5.00: Physical Therapist.
(3)
Occupational
Therapist. An occupational therapist must be currently licensed by
and in good standing with the Massachusetts Division of Professional Licensure,
Board of Allied Health Professionals as an occupational therapist.
(4)
Occupational Therapy
Assistant (OTA). An OTA must be currently licensed by and in good
standing with the Massachusetts Division of Professional Licensure, Board of
Allied Health Professionals as an OTA. OTAs must work under the supervision of
a licensed occupational therapist. Supervision of OTAs must be performed
following state regulatory guidance. For occupational therapy, see 259 CMR
3.00: Occupational Therapists.
(5)
Speech/Language Therapist (Speech/Language
Pathologist). A speech/language pathologist must be currently
licensed by and in good standing with the Massachusetts Board of Registration
in Speech-language Pathology and Audiology as a speech/language therapist or
speech/language pathologist.
(6)
Speech/Language Therapist Assistant (Speech/Language Pathologist
Assistant (SLPA)). An SLPA must be currently licensed by and in
good standing with the Massachusetts Board of Registration in Speech-language
Pathology and Audiology as an SLPA. An SLPA must work under the supervision of
a licensed Speech/Language pathologist. Supervision of SLPAs must be performed
following state regulatory guidance. For speech/language pathologist,
see 260 CMR 10.00: Use and Supervision of
Speech-language Pathology and Audiology Assistant.
(E)
Therapy Group
Practice. To participate in MassHealth as a Therapy Group
Practice, a group practice
(1) must have a
MassHealth provider number;
(2)
must be composed of physical, occupational, or speech/language therapists (or
any combination of the three), each of whom has an individual provider number;
(3) must have a physical location
that meets the requirements of 130 CMR 432.406(B);
(4) must be financially viable and must at
all times be able to have adequate resources to finance the provision of
services; and
(5) may include PTAs,
OTAs, and SLPAs who provide services subject to the supervision requirements of
130 CMR 432.404(D).
