Provider Eligibility: In State

Payment for the services described in 130 CMR 432.000 will be made only to therapists who are participating in MassHealth on the date of service, for services personally rendered by therapists or for services rendered by licensed therapy assistants, subject to the supervision requirements of 130 CMR 432.404(D). To participate in MassHealth as an in-state MassHealth provider, the provider must (A) obtain a MassHealth Provider number before providing therapy services; (B) notify the MassHealth agency in writing within 14 days of any change in any of the information submitted in the provider application in accordance with 130 CMR 450.223(B): Provider Contract: Execution of Contract, including, but not limited to, change of ownership, change of address, and addition or deletion of a branch office; (C) meet all applicable state and federal regulatory requirements, including but not limited to 101 CMR 339.00: Rates for Restorative Services, 130 CMR 432.000, and 130 CMR 450.000: Administrative and Billing Regulations; and (D) meet the applicable requirements below. (1) Physical Therapist. A physical therapist must be currently licensed by and in good standing with the Massachusetts Division of Professional Licensure, Board of Allied Health Professionals as a physical therapist. (2) Physical Therapist Assistant (PTA). A PTA must be currently licensed by and in good standing with the Massachusetts Division of Professional Licensure, Board of Allied Health Professionals as a PTA. PTAs must work under the supervision of a licensed physical therapist. Supervision of PTAs must be performed following state regulatory guidance. For physical therapy, see 259 CMR 5.00: Physical Therapist. (3) Occupational Therapist. An occupational therapist must be currently licensed by and in good standing with the Massachusetts Division of Professional Licensure, Board of Allied Health Professionals as an occupational therapist. 4) Occupational Therapy Assistant (“OTA”). An OTA must be currently licensed by and in good standing with the Massachusetts Division of Professional Licensure, Board of Allied Health Professionals as an OTA. OTAs must work under the supervision of a licensed occupational therapist. Supervision of OTAs must be performed following state regulatory guidance. For occupational therapy, see 259 CMR 3.00: Occupational Therapists. (5) Speech/Language Therapist (Speech/Language Pathologist). A speech/language pathologist must be currently licensed by and in good standing with the Massachusetts Board of Registration in Speech-language Pathology and Audiology as a speech/language therapist or speech/language pathologist. (6) Speech/Language Therapist Assistant (Speech/Language Pathologist Assistant (SLPA)). An SLPA must be currently licensed by and in good standing with the Massachusetts Board of Registration in Speech-language Pathology and Audiology as an SLPA. An SLPA must work under the supervision of a licensed Speech/Language pathologist. Supervision of SLPAs must be performed following state regulatory guidance. For speech/language pathology, see 260 CMR 10.00: Use and Supervision of Speech-language Pathology and Audiology Assistant. (E) Therapy Group Practice. To participate in MassHealth as a Therapy Group Practice, a group practice (1) must have a MassHealth provider number; (2) must be composed of physical, occupational, or speech/language therapists (or any combination of the three), each of whom has an individual provider number; (3) must have a physical location that meets the requirements of 130 CMR 432.406(B); (4) must be financially viable and must at all times be able to have adequate resources to finance the provision of services; and (5) may include PTAs, OTAs, and SLPAs who provide services subject to the supervision requirements of 130 CMR 432.404(D).