MedicaidPrior AuthMedium impact
MMP 23-45: Change in Non-Routine Therapy Prior Authorization (PA) Requirements for Medicaid Beneficiaries Residing in a Nursing Facility
Michigan Medicaid - MDHHS·MI · Occupational Therapy, Physical Therapy, Speech Therapy·Prior Authorization
Effective date
Aug 1, 2023
We identified it
Jun 20, 2026
Summary
Michigan Medicaid is removing prior authorization requirements for occupational therapy, physical therapy, and speech therapy services provided to nursing facility residents during their first 60 days of admission, effective August 1, 2023. After 60 days, prior authorization will be required every 60 days for continued therapy services.
Action Required
By August 1, 2023: Billing team must update prior authorization workflows to remove PA requirements for OT, PT, and speech therapy services during the first 60 days of nursing facility admission for Michigan Medicaid beneficiaries. After day 60, obtain PA every 60 days for continued therapy. Update billing system to track admission dates and therapy authorization periods. Ensure physician prescriptions or documented clearance are retained in medical records.