OCCUPATIONAL THERAPY SERVICES PROVIDER IN ALABAMA

Fatumata Kaba
Jun 30
4 min read

SUPPORTING INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES IN ACHIEVING INDEPENDENCE THROUGH SKILL DEVELOPMENT AND THERAPEUTIC INTERVENTION

Occupational Therapy Services in Alabama are designed to support individuals with intellectual and developmental disabilities (IDD) by improving their ability to perform daily living tasks, enhancing motor and sensory functioning, and promoting greater independence in home and community settings. These medically necessary services are delivered by licensed occupational therapists and are authorized under Alabama’s Home and Community-Based Services (HCBS) Medicaid Waivers, following standards established by the Alabama Department of Mental Health (ADMH).

1. GOVERNING AGENCIES

Agency: Alabama Department of Mental Health (ADMH)

Role: Regulates provider approval, defines service standards, and ensures compliance with therapeutic service delivery under HCBS waivers

Agency: Alabama Medicaid Agency

Role: Oversees Medicaid enrollment, reimbursement, and service codes for Occupational Therapy Services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and ensures therapeutic services meet HCBS Medicaid guidelines

2. OCCUPATIONAL THERAPY SERVICE OVERVIEW

Occupational Therapy Services focus on the evaluation and treatment of individuals with functional limitations that interfere with independence in areas such as self-care, work, play, and social participation. Services must be person-centered and included in the individual’s service plan. Approved providers may deliver:

Comprehensive functional evaluations
Development and implementation of individualized therapeutic interventions
Training in activities of daily living (ADLs) and instrumental ADLs
Sensory integration and motor skill development
Adaptation of environments and use of assistive devices
Caregiver education and support strategies

All services must be medically necessary, provided by a licensed occupational therapist, and documented in alignment with ADMH and Medicaid requirements.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Alabama Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Employ or contract with a Licensed Occupational Therapist (OT) and/or Certified Occupational Therapy Assistant (COTA)
Maintain a HIPAA-compliant clinical environment for service delivery
Develop clinical documentation systems aligned with Medicaid billing and therapy protocols
Demonstrate the ability to perform evaluations, maintain client records, and track therapeutic progress

4. ADMH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Request the Occupational Therapy Services Provider Application Packet from ADMH
Submit a clinical service model including therapist qualifications, treatment procedures, and outcome tracking
Include copies of licensure, supervisory structures, and documentation templates

Background & Credentialing:

Background checks for all therapy and support staff
Proof of active Alabama licensure for occupational therapists and assistants
Verification of continuing education, liability insurance, and professional certification

Program Readiness Review:

Evaluation of assessment tools, service plans, and therapy documentation forms
Review of clinical documentation, HIPAA compliance, and service delivery models
Demonstration of measurable outcome tracking and quality assurance practices

Approval & Medicaid Enrollment:

Once approved by ADMH, complete enrollment with Alabama Medicaid as a provider of Occupational Therapy Services
Add appropriate CPT/HCPCS billing codes to your service profile

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC Certificate
IRS EIN Letter
NPI confirmation
Facility lease or service location documentation
Licensure and certification for all clinical staff
ADMH-Compliant Policy & Procedure Manual including:
- Eligibility, referral, and evaluation processes
- Service planning and treatment documentation protocols
- Clinical supervision and reassessment policies
- Confidentiality, HIPAA compliance, and informed consent
- Emergency, grievance, and fraud prevention procedures
- Progress notes, goal tracking forms, and therapy logs
Signed individual service plans and therapy consent forms

6. STAFFING REQUIREMENTS

Role: Licensed Occupational Therapist (OT)Requirements: Master's degree or higher in Occupational Therapy, Alabama state license, experience in IDD services preferred

Role: Certified Occupational Therapy Assistant (COTA) (optional)Requirements: Associate’s degree in OTA, Alabama state certification, supervision by licensed OT

All staff must complete:

ADMH orientation and HCBS Waiver training
Annual training in documentation standards, safety protocols, and therapeutic best practices
Ongoing education in therapy techniques, disability support, and ethics

7. MEDICAID WAIVER SERVICES

The following Alabama Medicaid Waivers authorize Occupational Therapy Services: