MedicaidPrior AuthMedium impact
MSA 19-23
Michigan Medicaid - MDHHS·MI · Occupational Therapy, Physical Therapy, Speech Therapy·Provider Bulletin
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Michigan Medicaid clarified that home health therapy services (occupational, physical, and speech therapy) do not require prior authorization for up to 24 visits within the first 60 consecutive days each calendar year, but prior authorization is required for continuation beyond these limits. Form MSA-115 must be submitted at least 15 business days before the requested start date for continued services.
Action Required
By September 15, 2019: Billing team must update prior authorization workflows for Michigan Medicaid home health therapy services. Remove prior auth requirements for initial 24 visits within first 60 days each calendar year for occupational, physical, and speech therapy. Ensure Form MSA-115 is submitted at least 15 state business days before start date for services beyond 24 visits. Update system to track visit counts per calendar year. Failure to obtain timely prior auth may result in payment delays or denials.