MedicaidPrior AuthMedium impact
2025.86 - Changes to Prior Authorization of Physical, Occupational, and Speech Therapies for Individuals Whose Primary Diagnosis is Intellectual Disability, Developmental Delay, Autism or Other Developmental Disorder
Connecticut Medicaid (HUSKY Health)·CT · Physical Therapy, Occupational Therapy, PM&R (Physical Medicine & Rehab)·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid is changing prior authorization requirements for physical, occupational, and speech therapy services for patients with intellectual disability, developmental delay, autism, or other developmental disorders. Key changes include new medical necessity review criteria, 12-week authorization periods, elimination of IEP requirements for patients under 21, and new attestation requirements from treating therapists.
Action Required
Before January 1, 2026: Billing team must update prior authorization submission processes for therapy services (PT, OT, speech) for patients with intellectual disability, developmental delay, autism, or other developmental disorders on Connecticut Medicaid. Update documentation requirements to include therapist attestations for patients under 21 regarding school-based services overlap. Remove IEP collection requirements for these patients. Ensure reauthorization requests include minimum 4 treatment notes. Contact CHNCT at 1-800-440-5071 for PA process questions.