Overview

Provider Type

  • Physicians 
  • Participating Physician Groups (PPG)
  • Ancillary

Rehabilitation therapy (physical, speech, occupational, chiropractic, and respiratory) is covered after an acute illness or injury or an acute exacerbation of either. Coverage for continuation of rehabilitation is based on continuous functional improvement in response to the treatment plan. Rehabilitation services are deemed to be no longer medically necessary when there is objective evidence that the member has not demonstrated continuous functional improvement in response to the treatment plan.

The functional assessment of the member as related to the continuation of rehabilitation services is performed by one or more rehabilitation professionals.