REFERENCES: ARM 37.40.1461
PHYSICAL THERAPY SERVICES
Physical therapy services under the Big Sky Bonanza (BSB) program are provided in an outpatient setting
for maintenance, palliative, or restorative purposes or as an extension of Medicaid State Plan services.
Services are provided when the limits of physical therapy under the approved Medicaid State Plan are
exhausted. The scope and nature of these services do not otherwise differ from physical therapy services
furnished under the Medicaid State Plan. This is a traditional waiver service.
Maintenance physical therapy is provided when Medicaid State Plan services are denied and there is no
expectation that the consumer's condition will improve significantly in a reasonable and predictable time
period. Maintenance physical therapy is reimbursable only under the Home and Community Based
Services (HCBS) or BSB Waiver programs.
In addition to maintenance therapy provided under BSB, physical therapy may also be restorative or
palliative and provided when therapy limits exceed what is allowable under Medicaid State Plan. Extended
Medicaid State Plan physical therapy services are those defined in ARM 37.86.601.
Physical therapy services must be provided by a licensed physical therapist. A physical therapist's
assistant, student, or aide may assist in the practice of physical therapy under the direct supervision of a
licensed physical therapist who is responsible for and participates in the treatment program.
Effect on Support Services and Spending Plan (SSSP)
Only those physical therapy services provided under BSB are included on the SSSP. The provision of
Medicaid State Plan physical therapy services as defined in ARM 37.40.1102 should be reflected in the
Supports Section of the SSSP.
Restorative, palliative, or maintenance physical therapy under BSB may not be reimbursed until Medicaid
State Plan limits are met.
August 1, 2008 Senior & Long Term Care Page 1 of 1