|
28.2 Benefits, Limitations, and Authorization Requirements
The CSHCN Services Program may reimburse medically necessary and appropriate outpatient PT and OT for CSHCN Services Program clients. A physician or podiatrist (for conditions below the ankle) must prescribe PT and OT services that are provided through or in a rehabilitation center, a licensed hospital, a physician's office, or the office of an enrolled PT or OT provider. The CSHCN Services Program may reimburse therapists for travel to the client's community, based on standard CSHCN Services Program travel reimbursement policy, when no local therapist is available or when services are provided in the client's home. Use the CSHCN Services Program local procedure code 100PT, Transportation therapist, per mile. Only licensed therapists may provide PT and OT services.
The CSHCN Services Program reimburses therapists and outpatient facilities based on the procedure codes listed in this chapter. Therapy sessions include the time span the therapist is with the client, time spent preparing the client for the session, and the time spent completing documentation.
|
