Physical/Occupational Therapy. This plan covers physical and occupational therapy when: • ordered by a physician; • received from a licensed physical or occupational therapist; • a program is implemented to provide habilitative or rehabilitative services. See Autism Services when physical therapy and occupational therapy services are rendered as part of the treatment of autism spectrum disorder. The amount you pay and any benefit limit will be the same whether the services are provided for habilitative or rehabilitative purposes.
Physical/Occupational Therapy. Physical and occupational therapy is covered only when: a program is implemented to restore or attain a higher level of independent functioning or new skills in the most timely manner possible; physical or occupational therapy is received from a licensed physical or occupational therapist; physical or occupational therapy is ordered by a doctor; the therapy will result in significant, sustained measurable functional or skill status given your condition; and such improvement will not diminish with the removal of the therapeutic agent or environment. Preauthorization is recommended for the eleventh and subsequent visit. Inpatient Medically necessary inpatient physical or occupational therapy is covered as a hospital service. See Section 8.0.
Physical/Occupational Therapy. Physical and occupational therapy is covered only when: a program is implemented to restore the highest level of independent functioning in the most timely manner possible; physical or occupational therapy is received from a licensed physical or occupational therapist; physical or occupational therapy is ordered by a doctor; the therapy will result in significant, sustained measurable functional or anatomical improvement of your condition; and such improvement will not diminish with the removal of the therapeutic agent or environment. Physical therapy and occupational therapy services provided for habilitative or rehabilitative purposes are covered at the same benefit level. Inpatient Medically necessary inpatient physical or occupational therapy is covered as a hospital service. See Section 8.0.
Physical/Occupational Therapy. Outpatient hospital/in a doctor’s/therapist’s office Limited to thirty (30) physical therapy visits and (30) occupational therapy visits per member per plan year. 20% - After Deductible 20% - After Deductible
Physical/Occupational Therapy. Physical and occupational therapy is covered only when: • a program is implemented to restore or attain a higher level of independent functioning or new skills in the most timely manner possible; • physical or occupational therapy is received from a licensed physical or occupational therapist; • physical or occupational therapy is ordered by a doctor; • the therapy will result in significant, sustained measurable functional or skill status given your condition; and • such improvement will not diminish with the removal of the therapeutic agent or environment.
Physical/Occupational Therapy. Physical and occupational therapy is covered only when: • a program is implemented to restore the highest level of independent functioning in the most timely manner possible; • physical or occupational therapy is received from a licensed physical or occupational therapist; • physical or occupational therapy is ordered by a doctor; • the therapy will result in significant, sustained measurable functional or anatomical improvement of your condition; and • such improvement will not diminish with the removal of the therapeutic agent or environment. Inpatient Medically necessary inpatient physical or occupational therapy is covered as a hospital service. See Section 8.0.
Physical/Occupational Therapy. Outpatient hospital/in a physician’s/therapist’s office. 20% - After deductible 40% After deductible
Physical/Occupational Therapy. Outpatient hospital when therapy is rendered within the first 30- days following a hospital stay; home care program or ambulatory surgical procedure. Limited to thirty (30) physical therapy visits and 30 occupational therapy visits per member per plan year. 0% - After deductible 20% - After deductible Outpatient hospital (after the first 30 days) or in a doctor’s/therapist’s office. Limited to thirty (30) physical therapy visits and 30 occupational therapy visits per member per plan year. 20% - After deductible 20% - After deductible
Physical/Occupational Therapy. This plan covers physical and occupational therapy when: ordered by a physician; received from a licensed physical or occupational therapist; a program is implemented to provide habilitative or rehabilitative services. DN: Insert if applicable Physical or occupational therapy services received outpatient in a hospital facility are covered. The level of coverage differs depending on whether the therapy is rendered within the first thirty (30) days following a hospital stay, a home care program, or an ambulatory surgical procedure to treat or diagnose a condition requiring physical rehabilitation which is rehabilitative in nature. See the Summary of Medical Benefits for benefit limits and the amount you pay. See Autism Services when physical therapy and occupational therapy services are rendered as part of the treatment of autism spectrum disorder. The amount you pay and any benefit limit will be the same whether the services are provided for habilitative or rehabilitative purposes.
Physical/Occupational Therapy. Physical and/or occupational therapy is covered only when a program is implemented to restore the highest level of independent functioning in the most timely manner possible and: • physical or occupational therapy is received from a licensed physical or occupational therapist; • we determine that the therapy will result in significant, sustained measurable functional/anatomical improvement of your condition; and • such improvement will not diminish with the removal of the therapeutic agent or environment. Inpatient Medically necessary inpatient physical or occupational therapy is covered as a hospital service listed in Section 7.0. Outpatient/ In a Doctor's or Therapist's Office We cover medically necessary physical and/or occupational therapy services. See the Summary of Benefits for benefit limits and level of coverage. In Your Home
