Missouri manual section 6.25
Physical therapy
Official service name: Physical Therapy
Physical therapy can evaluate and treat physical-motor needs through habilitative or rehabilitative strategies that help a person function as independently as possible. It may include a treatment plan, direct therapy, consultation, and training for caregivers or other support providers.
What the manual describes
What this service can help with
- Evaluating physical-motor function and developing a treatment plan
- Building or maintaining adaptive movement and functional independence
- Direct physical therapy based on developmental, habilitative, or rehabilitative needs
- Training and consultation for parents, caregivers, and other support providers
- Coordinating physical-therapy strategies with other programs or habilitation services
Source-backed working pathway
To establish you'll probably need:
These steps translate the cited manual section into a practical review sequence. Confirm the current local process before acting.
Describe the physical-motor need and intended outcome.
Identify the movement, positioning, strength, mobility, transfer, endurance, or other functional concern and connect it to a person-centered outcome.
Check the Medicaid state-plan therapy pathway.
Determine whether state-plan rehabilitation or Healthy Children and Youth services can meet the need. Document why waiver therapy is additional and nonduplicative when the waiver pathway is proposed.
Obtain a physician prescription and physical-motor evaluation.
Secure the physician's prescription and a certified physical therapist's evaluation identifying the need, recommended approach, and treatment goals.
Identify a licensed and contracted physical therapist.
Confirm Missouri licensure and the required Department contract. If an assistant will participate, confirm that the physical therapist will provide the required supervision.
Confirm authorization and the treatment plan.
Verify the authorized scope and units, the eight-unit daily maximum, caregiver-training needs, any virtual-delivery plan, progress-note requirements, and the date for annual reevaluation.
Important boundaries
Limits that may affect fit or authorization
- A physician prescription and physical-motor evaluation are required.
- Medicaid state-plan services must be used first when they can meet the need, and waiver physical therapy cannot duplicate state-plan therapy.
- For adults, the manual distinguishes state-plan rehabilitative therapy from the additional habilitative therapy available through the waiver.
- For children, medically necessary state-plan services through Healthy Children and Youth must be accessed first when applicable.
- A certified physical therapy assistant may provide direct therapy only under a physical therapist's supervision.
- Virtual delivery must meet the additional requirements in Manual Section 7.
- The manual lists fifteen-minute units and a maximum of eight units per day.
- A written evaluation must be completed at least annually, and the physician prescription must remain on file.
- Comprehensive and Community Support waivers remain under a temporary renewal extension through December 27, 2026, or until CMS grants final approval. Confirm the currently approved rules with the support coordinator; proposed renewal changes are not automatically active.
Do not assume this part
Questions to confirm locally
- What functional outcome should physical therapy address?
- Can the need be met through the Medicaid state plan or Healthy Children and Youth?
- Is the physician prescription current and on file?
- What does the physical-motor evaluation recommend?
- Is the provider licensed, contracted, and able to supervise any assistant?
- Will any service be virtual, and which Section 7 requirements apply?
- How many units are authorized, and when is the annual reevaluation due?