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Habilitation Services Definition and Coverage Effective January 1, 2014

Maryland Medicaid·MD · Physical Therapy, Occupational Therapy, Speech Therapy +2 more·Managed Care Organizations
Effective date
Jan 1, 2014
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medicaid managed care organizations must now cover habilitation services to help individuals with disabilities develop and maintain skills for daily living and community integration. This establishes standardized coverage requirements and definitions for developmental and rehabilitative services that were previously inconsistently covered.

Action Required

Action needed
By January 1, 2014: Billing teams serving Maryland Medicaid managed care patients should verify coverage for habilitation services including physical therapy, occupational therapy, speech therapy, and behavioral interventions for patients with developmental disabilities. Update prior authorization workflows to align with new coverage definitions. Contact Maryland Medicaid managed care plans to obtain specific billing guidelines and any required documentation requirements for habilitation services.