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Quick Reference - Therapy Types

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Types of Therapy Services

Therapy services may be available to Division Members who are also eligible for the Arizona Long-Term Care System (ALTCS). The Division or the member’s DDD Health Plan (Mercy Care, UnitedHealthcare Community Plan, or DDD Tribal Health Program) may provide the services.

Therapy Services include Occupational Therapy (OT), Physical Therapy (PT), and Speech-Language Pathology (SLP). These services are based on medical necessity for the member including habilitative/developmental and rehabilitative/restorative.

  • Habilitative, also known as Developmental, focuses on maintaining existing skills, learning new skills, and improving life quality. It promotes skills in everyday tasks. It helps people learn and improve their skills in speaking, walking, or eating.
  • Rehabilitative, also known as Restorative, focuses on getting back lost skills and functions due to life events like illness or injury. It helps individuals adapt and regain independence.

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Administration of Therapy Services

  • Habilitative Therapy Services: Coordinated and provided by Division contractors and monitored by the Division.
  • Rehabilitative Therapy Services: Coordinated and provided by DDD Health Plan contracted providers and monitored by the Division.

Coverage by Therapy Type and Member’s Age

Therapy services for members aged 0 to 3 years may be provided by the Arizona Early Intervention Program (AzEIP). The Raising Special Kids website has more information on AzEIP services including therapies.

Occupational Therapy (OT)

  • Younger Than 21 Years: Covered by both the Division and DDD Health Plans.
    • The DDD Health Plans cover rehabilitative OT services. The DDD Health Plans cover habilitative OT services for members who receive them at a Multi-Specialty Interdisciplinary Clinic (MSIC).
    • DDD covers habilitative OT services.
  • 21 Years and Older:
    • The DDD Health Plans cover both types of therapy services. This includes:
      • Up to 15 visits per contract year for habilitative OT services and;
      • 15 visits per contract year for rehabilitative OT services.
    • DDD covers habilitative OT services.

Physical Therapy (PT)

  • Younger Than 21 Years: Covered by both the Division and DDD Health Plans.
    • The DDD Health Plans cover rehabilitative PT services. The DDD Health Plans cover habilitative PT services provided at a Multi-Specialty Interdisciplinary Clinic (MSIC).
    • DDD covers habilitative PT services.
  • 21 Years and Older:
    • The DDD Health Plans cover both types of therapy services. This includes:
      • Up to 15 visits per contract year for habilitative PT services and;
      • 15 visits per contract year for rehabilitative PT services.
    • DDD does not cover habilitative PT services for ALTCS members older than 21.

Speech-Language Pathology (SLP)

  • Younger Than 21 Years: Covered by both the Division and DDD Health Plans.
    • The DDD Health Plans cover rehabilitative SLP therapy services. The DDD Health Plans cover habilitative SLP services provided at a Multi-Specialty Interdisciplinary Clinic (MSIC).
    • DDD covers habilitative SLP services.
  • 21 Years and Older:
    • The DDD Health Plans cover rehabilitative SLP therapy services.
    • DDD covers habilitative SLP therapy services.

Members with questions can contact their Support Coordinator, or the DDD Customer Service Center at 1-844-770-9500, option 1.

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