Outpatient Rehabilitation. Rehabilitation Therapy provided on an Outpatient basis by a facility or professional provider. Routine Foot Care Benefits for Medically Necessary Routine foot care, when obtained from a Covered Provider. Substance Use Disorder Benefits for Substance Use Disorder will be paid as any other Illness. Care and treatment for Substance Use Disorder, when the Member is not an Inpatient Member, and provided in or by:
Outpatient Rehabilitation. Treatment by the provider in charge of the case for outpatient rehabilitation is limited to 60 visits per calendar year; 120 visits per lifetime: the subscriber‟s illness or injury requires at least three days of hospitalization; the subscriber‟s condition requires skilled nursing care for continued treatment; and the subscriber is admitted to the skilled nursing facility within 14 days following discharge from an accredited hospital. These services in a skilled nursing facility are limited to two visits during the first week of confinement and one visit a week for each consecutive week of confinement thereafter. Each day of confinement in a skilled nursing facility counts as one-half day against the total 365 days available for inpatient medical services.
