Licensed professionals: The patient’s condition, or the complexity of the service, requires the judgment, knowledge, and skills of qualified licensed professionals.
Daily rehabilitation services: Coverage is based on an assessment of the patient’s restoration potential and meeting at least one of these expectations:
- The patient’s condition will improve in a reasonable and generally predictable period of time, or
- Daily services are necessary to establish a safe and effective home or long-term care program, or
- Daily services are necessary to prevent the patient's condition from getting worse