Habilitative Services for Children. Covered services provided for habilitative services for children through age 19 with a congenital, genetic, or early acquired disorder so long as all of the following conditions are met:
Habilitative Services for Children. A. Covered Benefits Benefits for Habilitative Services are available for Dependent children under the age of twenty-one (21) years and include Occupational Therapy, Physical Therapy, and Speech Therapy.
B. Conditions and Limitations Benefits are not covered for Habilitative Services delivered through early intervention or school services. Prior authorization is required. Benefits are not counted toward any visit maximum for Physical Therapy, Occupational Therapy or Speech Therapy services stated in the Schedule of Benefits.
Habilitative Services for Children. Clinical trials; CareFirst reserves the right to make changes to the categories of services that are subject to utilization management requirements or to the procedures Members and/or providers must follow. CareFirst will notify Subscribers of these changes at least thirty (30) days in advance.
Habilitative Services for Children. Habilitative Services are services for the treatment of a Dependent child with a congenital or genetic birth defect to enhance the child's ability to function. This includes a defect existing at or from birth, including a hereditary defect. A congenital or genetic birth defect includes, but is not limited to: autism or an autism spectrum disorder; and, cerebral palsy.
A. Benefits for Habilitative Services will be provided for:
1. Dependent children under the age of 19 years; and
2. Include occupational therapy, physical therapy, and speech therapy. Benefits are not available for Habilitative Services delivered through early intervention and school services. Prior authorization is required for Habilitative Services or for any other service provided by the same provider on the same day as these services.
B. Benefits are subject to the office visit Copayment, as stated in the Schedule of Benefits, but are not counted toward any visit maximum for therapy services.
Habilitative Services for Children. Coverage is provided for Medically Necessary habilitative Services. Habilitative Services means Health Care Services and devices, including Services and devices for the treatment of a child that help
1. Therapeutic care means services provided by a speech-language pathologist, occupational therapist or physical therapist. 2. Behavioral health treatment means professional counseling and treatment programs, including applied behavior analysis, that are necessary to develop, maintain or restore, to the maximum extent practicable, the functioning of an individual. 3. Psychological care means direct or consultative services provided by a psychologist or social worker. See the benefit-specific limitations and exclusions immediately below for additional information.
