Question

Which of the following statements is not true regarding Medicaid Prior Authorizations?

1) The number of sessions may exceed the approved quantity as long as you do not treat beyond the expiration date
2) There are two parts, a PA/RF and PA/TA
3) There is some flexibility with frequency as long as you have it written in your POC and have a physician order that allows it
4) Your PA must be into the Medicaid office within 14 days of evaluation

Answer 1

The number of sessions may not exceed the approved quantity as long as you do not treat beyond the expiration date, Medicaid Prior Authorizations consist of two parts: PA/RF and PA/TA, and submitting the PA within 14 days is important.

Step-by-step explanation:

Regarding Medicaid Prior Authorizations, the statement that is not true is: The number of sessions may exceed the approved quantity as long as you do not treat beyond the expiration date. In reality, the number of sessions should not exceed the approved quantity, regardless of the expiration date.

There are indeed two parts to Medicaid Prior Authorizations, which are PA/RF (Prior Authorization/Request for) and PA/TA (Prior Authorization/Tracking Authorization).

There is some flexibility with the frequency of sessions, but this flexibility should be written in the Plan of Care (POC) and supported with a physician order.

It is important to submit your PA to the Medicaid office within 14 days of evaluation to ensure timely processing.