Physical Therapy, Occupational Therapy, and Speech Therapy Update

Date: 04/15/22

Fort Lauderdale, Florida

We want to share an important update to the authorization requirements for Sunshine Health, Serious Mental Illness (SMI) Specialty Plan and Child Welfare Specialty Plan members. 

Members up to 3-years old and younger do not require authorization for physical therapy (PT), occupational therapy (OT) or speech therapy (ST).

Members 3-years old and up will still require prior authorization through HN1 except if service is in a PPEC, EIS, or hospital outpatient facility. Those services will continue to be reviewed by Sunshine Health.

There is no change to the authorization requirements for Children’s Medical Services (CMS) Health Plan members. CMS members will continue to be authorized by Evicore for all service locations.

You can find more information on our Pre-Auth Check Tool by scrolling down to Ancillary Services toward the bottom of the page.

For questions or concerns, please contact Sunshine Health Provider Services at 1-844-477-8313. Stay up to date on any provider notices by reviewing and bookmarking Provider News.