OT/PT/ST Therapy
Services

Therapy Services

Acentra Health, the QIO-like organization for the Arkansas Department of Human Services (DHS), provides utilization and quality control peer review for Speech Therapy (ST), Occupational Therapy (OT), and Physical Therapy (PT) for Medicaid Beneficiaries Receiving More Than Ninety (90) Minutes per Week services to qualifying Arkansas Medicaid beneficiaries.

Speech Therapy (ST), Occupational Therapy (OT), and Physical Therapy (PT) for Medicaid Beneficiaries Receiving More Than Ninety (90) Minutes per Week will be processed as follows:

  1. Acentra will process all prior authorization requests according to their program type.
    1. a. Therapy program type (21, 42, 43) within seventy-two (72) hours of receipt of complete documentation clearly establishing medical necessity.
    2. b. EIDT program type (24) within nine (9) days of receipt of complete documentation clearly establishing medical necessity.
  2. All reviews will be conducted by a licensed speech, occupational, or physical therapist depending on the type of service under review.
  3. If a PA request does not contain documentation clearly establishing that the requested services are medically necessary, Acentra will refer the request to a peer reviewer or physician advisor who will determine whether to enter a determination that some or all of the requested care is not medically necessary (adverse decision).