Benefit limits and prior authorization requirements for rehabilitative therapy services
Review the benefit limits and prior authorization requirements for rehabilitative therapy services (physical, occupational and speech therapy) for UnitedHealthcare Community Plan of Arizona members in accordance with the AHCCCS Medical Policy Manual Ch 310-X.
Before providing rehabilitative therapy services to our members, please be sure to review the applicable prior authorization lists for Arizona Health Care Cost Containment System (AHCCCS) Complete Care (ACC), Developmentally Disabled (DD), and Long-Term Care (ALTCS).
Please note that prior authorization is required for all services rendered by out-of-network providers.
Rehabilitative therapy services for members younger than 21
Prior authorization is required as indicated on the prior authorization lists, except for services rendered to a CRS or Formerly CRS designated member, rendered in an in-network Multi-Specialty Interdisciplinary Clinic (MSIC). Services rendered to these members, in an in-network MSIC do not require prior authorization.
Prior authorization is not required and there are no benefit limits for inpatient physical, occupational or speech therapy services when rendered by an in-network provider.
Rehabilitative therapy services for members ages 21 and older
For ACC and DD members:
For ALTCS members:
For QMB Members:
If you have questions, please call Provider Services at 800 445 1638 for ACC and DD, or 800 293 3740 for ALTCS.