Health First Colorado Outpatient Physical and Occupational Therapy Benefits Frequently Asked Questions
- Do I need a referral or a provider’s permission to get Outpatient Physical and Occupational Therapy (PT/OT)?
Yes. Your primary care doctor, or the hospital you are discharged from, may refer you to a physical or occupational therapist to help you recover. You may also go directly to a therapist for care, but that therapist must contact your primary care doctor to get approval for your treatment plan.
Children ages 0 to 3 may receive Outpatient Physical and Occupational Therapy (PT/OT) without a referral if it is coordinated through Early Intervention Colorado.
- How many times can I get Outpatient Physical and Occupational Therapy services?
The benefit does not have a hard-annual limit for children or adults. The benefit is limited by the number of visits which are authorized.
Your provider will be able to help answer your questions about PT/OT services and how many you are able to get in 12 months.
You can read about the PT/OT services a Health First Colorado (Colorado’s Medicaid Program) member can get on the Benefits & Services page.
You can also contact the Health First Colorado Member Contact Center for more information.
- I receive Health First Colorado services through a waiver program. How many Outpatient Physical and Occupational Therapy (PT/OT) hours do I get?
Health First Colorado (Colorado’s Medicaid Program) members who get services through a waiver program have Outpatient Physical and Occupational Therapy covered to the same extent as members who are not enrolled on a waiver program.
- What is Outpatient Physical and Occupational Therapy?
Physical and Occupational Therapies (PT/OT) are services meant to help you recover from an acute injury, illness, or surgery. Some therapies are meant to help you maintain physical ability, or help children reach developmental milestones.
PT/OT is performed by licensed professionals. Health First Colorado (Colorado’s Medicaid Program) limits the number of PT/OT services you can get in a year. Get more information on PT/OT limits.
- Where can I find more information about Outpatient Physical and Occupational Therapy (PT/OT) services?
Your provider will be able to help answer questions about your Outpatient Physical and Occupational Therapy (PT/OT) services.
You can read about the PT/OT services Health First Colorado (Colorado’s Medicaid Program) member can get in our Benefit Coverage Standard or on our Benefits & Services page.
- Where can I get Outpatient Physical and Occupational Therapy services?
You can get Outpatient Physical and Occupational Therapies (PT/OT) at a clinic, a rehab center, or a hospital. Your provider can help you pick the best place for you to get therapy services.
