Therapy Services: Definitions

01. Duplicate Services. Services are considered duplicate: (7-1-26) a. When participants receive any combination of physical therapy, occupational therapy, or speech- language pathology services with treatments, evaluations, treatment plans, or goals that are not separate and unique to each service provided; or (7-1-26) b. When more than one (1) type of therapy is provided at the same time. (7-1-26) 02. Feeding Therapy. Services necessary for the treatment of feeding disorders. (7-1-26) 03. Maintenance Program. A program that requires the skills of a therapist or therapy professional and consists of activities and mechanisms to assist a participant in maximizing or maintaining the progress they have made during therapy or to prevent or slow further deterioration due to a disease or illness. (7-1-26) 04. Occupational Therapy Services. Therapy services that: (7-1-26) a. Are necessary for the evaluation and treatment of impairments, functional disabilities, or changes in physical function and health status; and (7-1-26) b. Improve the ability to perform tasks required for independent functioning. (7-1-26) 05. Physical Therapy Services. Therapy services that: (7-1-26) a. Are necessary for the evaluation and treatment of physical impairment or injury using therapeutic exercise and the application of modalities to restore optimal function or normal development; and (7-1-26) b. Focus on the rehabilitation and prevention of neuromuscular, musculoskeletal, integumentary, and cardiopulmonary disabilities. (7-1-26) 06. Speech-Language Pathology Services. Therapy services that are: (7-1-26) a. Necessary for the evaluation and treatment of speech and language disorders that result in communication disabilities; or (7-1-26) b. Necessary for the evaluation and treatment of swallowing disorders (dysphagia), regardless of the presence of a communication disability. (7-1-26) 07. Therapeutic Procedures. Therapeutic procedures are the application of clinical skills, services, or both, that attempt to improve function. (7-1-26) 08. Therapist. An individual licensed by the appropriate state licensing board as an occupational therapist, physical therapist, or speech-language pathologist. (7-1-26) 09. Therapy Professional. An individual licensed by the appropriate state licensing board as an occupational therapist or occupational therapist assistant, physical therapist or physical therapist assistant, or speech- language pathologist or speech-language pathology assistant. (7-1-26) IDAHO ADMINISTRATIVE CODE IDAPA 16.03.26 Department of Health & Welfare Medicaid Plan Benefits Section 251 Page 72 10. Therapy Services. Occupational therapy, physical therapy, and speech-language pathology services are therapy services. These services are ordered as part of a plan of care. (7-1-26)