Common use of Physical Medicine and Rehabilitation Services Clause in Contracts

Physical Medicine and Rehabilitation Services. A structured therapeutic program under the supervision of a physical medicine and rehabilitation specialist and developed treatment plan of an intensity that requires a multidisciplinary coordinated team approach to upgrade the patient's ability to function as independently as possible, including skilled rehabilitative nursing care, physical therapy, occupational therapy, speech therapy and services of a social worker or psychologist. The goal is to obtain practical improvement in a reasonable length of time in the appropriate Inpatient setting. Physical Medicine and Rehabilitation involves several types of therapy, not just physical therapy, and a coordinated team approach. The variety and intensity of treatments required is the major differentiation from an admission primarily for physical therapy. Long term rehabilitation for longer than 60 days in an inpatient setting is not a Covered Service. Day Rehabilitation Program services provided through a Day Hospital for physical medicine and rehabilitation are Covered Health Services. A Day Rehabilitation Program is for those patients who do not require Inpatient care but still require a rehabilitation therapy program four to eight hours a day, 2 or more days a week at a Day Hospital. Day rehabilitation program services may consist of Physical Therapy, Occupational Therapy, Speech Therapy, nursing services, and neuro psychological services. A minimum of two Therapy Services must be provided for this program to be a Covered Health Service.