Department of Health

Physical Therapy Services Provided by Clinics to Medicaid Recipients

We analyzed the claims paid by Medicaid over a 24-month period for physical therapy services provided by clinics. To be eligible for reimbursement, such services should be provided by currently licensed physical therapists. However, many of the claims did not positively affirm that the services were provided by such individuals. We therefore selected a sample of these claims for detailed examination. We visited the clinics, reviewed their records and determined that the services in our sample were provided by currently licensed physical therapists. To reduce the risk that payments may inappropriately be made for physical therapy services not provided by such individuals, we recommend claims for such services not be paid unless it is clearly indicated that the services were provided by such individuals.

For a complete copy of Report 2006-S-63 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.