THERAPY SERVICES PROVIDER IN OHIO

Fatumata Kaba
Sep 17
4 min read

ENHANCING PHYSICAL, COMMUNICATION, AND DEVELOPMENTAL OUTCOMES THROUGH SPECIALIZED THERAPEUTIC INTERVENTIONS

Therapy Services in Ohio offer individuals with disabilities, chronic health conditions, or developmental delays access to clinically prescribed interventions such as physical, occupational, and speech therapies. These services aim to improve functional abilities, promote independence, and support community living goals. Therapy Services are authorized under Ohio Medicaid Home and Community-Based Services (HCBS) Waiver programs and Medicaid State Plan benefits.

1. GOVERNING AGENCIES

Agency: Ohio Department of Medicaid (ODM)

Role: Oversees Medicaid coverage, billing authorization, and documentation standards for therapy services.

Agency: Ohio Department of Developmental Disabilities (DODD)**

Role: Coordinates therapy supports under developmental disability waivers and ensures integration into Individual Service Plans (ISPs).

Agency: Ohio Department of Health (ODH)**

Role: Oversees licensure for therapy professionals and outpatient therapy clinic operations.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Ensures Medicaid-funded therapy services meet federal HCBS and medical necessity guidelines.

2. THERAPY SERVICES OVERVIEW

Therapy services may be provided in a participant’s home, a licensed clinic, or community setting and must be prescribed based on assessed needs.

Approved providers may deliver:

Physical Therapy (PT): Improving mobility, strength, balance, and range of motion.
Occupational Therapy (OT): Enhancing daily living skills such as dressing, eating, and grooming.
Speech-Language Therapy (SLP): Supporting communication, speech clarity, and swallowing function.
Feeding and Swallowing Therapy: Addressing dysphagia and safe oral intake.
Sensory Integration Therapy: For individuals with sensory processing challenges.
Augmentative and Alternative Communication (AAC): Assessment and training on communication devices.
Developmental and Early Intervention Therapies: Promoting skill acquisition for children and youth.
Documentation: Progress reports, treatment logs, therapy goals, and Medicaid billing notes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Ohio Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid therapy provider through the Ohio Medicaid Provider Enrollment Portal.
Ensure therapists are licensed by the Ohio OT/PT/AT Board or Ohio Speech and Hearing Professionals Board.
Maintain general and professional liability insurance.
Develop clinical policies for assessment, documentation, HIPAA compliance, and treatment planning.

4. OHIO PROVIDER ENROLLMENT PROCESS

Initial Application:

Apply through the Ohio Medicaid Provider Enrollment system (MITS).
PT, OT, and SLPs must enroll as individual or group providers; agencies must be credentialed as therapy clinics.

Documentation Submission:

Licensure verification, business registration, insurance certificates, policy manuals, and provider agreements.

Readiness Review (if applicable):

State agencies may review site safety, credentialing records, and clinical compliance plans.

Final Approval:

Once approved, providers receive Medicaid billing credentials and can begin delivering services.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License
IRS EIN confirmation
NPI registration
Therapist licenses and background checks
Liability insurance documents
Therapy Services Policy & Procedure Manual including:
- Evaluation and treatment protocols
- Person-centered therapy planning guidelines
- Session tracking, documentation, and billing templates
- HIPAA compliance and informed consent procedures
- Emergency response and infection control plans
- Quality assurance monitoring tools and client satisfaction surveys

6. STAFFING REQUIREMENTS

Role: Clinical Director / Therapy Program Administrator

Requirements: Licensed PT, OT, or SLP with supervisory and Medicaid experience.

Role: Physical Therapists (PTs)**

Requirements: State license; experience with Medicaid or waiver populations preferred.

Role: Occupational Therapists (OTs)**

Requirements: State license; experience in ADL training, sensory integration, and home-based support.

Role: Speech-Language Pathologists (SLPs)**

Requirements: Ohio licensure and CCC-SLP preferred; experience with AAC or pediatric clients is a plus.

Role: Therapy Assistants (PTAs, COTAs, SLPTAs)**

Requirements: State license; work under the supervision of a licensed therapist.

All staff must complete:

HIPAA and rights-based service delivery training
Annual CEUs and professional license renewals
Medicaid documentation and compliance training
Safety, emergency response, and infection control modules

7. MEDICAID WAIVER PROGRAMS

Therapy Services are available under the following Ohio Medicaid programs:

Individual Options (IO) Waiver – via DODD
SELF Waiver – when included in the person’s budget
Level One Waiver – limited therapy supports
PASSPORT Waiver – therapy services via managed care
Ohio Home Care Waiver – PT/OT/SLP as needed
MyCare Ohio – through managed care organizations
State Plan Medicaid Therapy – accessible outside of waiver enrollment when medically necessary