| Is the Benefit Covered? |
Copayment Requirement |
Prior Approval Requirement |
Coverage Limitations |
Reimbursement Methodology |
Populations Covered |
|
|
Alabama
|
|
No
|
|
|
|
|
|
|
Alaska
|
|
Yes
|
|
|
|
Fee for service at 85% of physician fee
|
CN
|
|
Arizona
|
|
Yes
|
|
Yes
|
Rehab potential required
|
Fee for service
|
CN & MN
|
|
Arkansas
|
|
No
|
|
|
|
|
|
|
California
|
|
Yes
|
$1/visit
|
Treatment plan
|
Rehab potential required and to prevent hospitalization, 2 visits/month included in limits for other specified practitioners in any setting
|
Fee for service
|
CN & MN
|
|
Colorado
|
|
Yes
|
|
After initial 24 visits
|
|
Fee for service
|
CN
|
|
Connecticut
|
|
No
|
|
|
|
|
|
|
Delaware
|
|
Yes
|
|
|
|
Fee for service
|
CN
|
|
District of Columbia
|
|
Yes
|
|
Treatment plan
|
|
Fee for service
|
CN & MN
|
|
Florida
|
|
No
|
|
|
|
|
|
|
Georgia
|
|
No
|
|
|
|
|
|
|
Hawaii
|
|
Yes
|
|
Yes
|
Rehab potential required
|
Fee for service
|
CN & MN
|
|
Idaho
|
|
Yes
|
|
Treatment plan
|
25 home or ambulatory visits/year included in limits for other specified practitioners
|
Fee for service
|
CN
|
|
Illinois
|
|
Yes
|
|
Services other than to continue therapy provided in previous 30 days on inpatient basis
|
|
Fee for service or certified cost
|
CN & MN
|
|
Indiana
|
|
Yes
|
|
|
12 hours/30 days or 30 visits/30 days for treatment of acute condition following hospital discharge if ordered by physician
|
Fee for service
|
CN
|
|
Iowa
|
|
Yes
|
$1/day
|
|
Limited to services meeting Medicare standards
|
Fee for service
|
CN & MN
|
|
Kansas
|
|
Yes
|
|
|
Limited to post-trauma/illness only, rehab potential required
|
Fee for service
|
CN & MN
|
|
Kentucky
|
|
No
|
|
|
|
|
|
|
Louisiana
|
|
No
|
|
|
|
|
|
|
Maine
|
|
Yes
|
$.50-$2/day, depending on payment, up to $20/month
|
|
|
Fee for service
|
CN & MN
|
|
Maryland
|
|
No
|
|
|
|
|
|
|
Massachusetts
|
|
Yes
|
|
|
20 visits/year
|
Fee for service
|
CN & MN
|
|
Michigan
|
|
No
|
|
|
|
|
|
|
Minnesota
|
|
Yes
|
A - $3/visit
|
After initial 30 sessions
|
|
Fee for service
|
A & B - See state-specific FN
|
|
Mississippi
|
|
No
|
|
|
|
|
|
|
Missouri
|
|
Yes
|
|
|
Services covered in rehab centers only and only to adjust to prosthetics and orthotics after loss of limb or function
|
Fee for service
|
CN
|
|
Montana
|
|
Yes
|
$2/visit
|
|
40 hours/year
|
Fee for service
|
A & B - See state-specific FN
|
|
Nebraska
|
|
Yes
|
$1 or $3/specified services - see state-specific FN
|
|
Rehab potential required
|
Fee for service
|
CN & MN
|
|
Nevada
|
|
Yes
|
|
Yes
|
Rehab potential required
|
Fee for service
|
CN
|
|
New Hampshire
|
|
Yes
|
|
|
Eighty 15-minute time units/year included in limits with other specified practitioners
|
Fee for service
|
CN & MN
|
|
New Jersey
|
|
No
|
|
|
|
|
|
|
New Mexico
|
|
Yes
|
B - $7/visit with annual maximum across all services based on income, see state-specific FN
|
Yes
|
|
Fee for service
|
CN
|
|
New York
|
|
Yes
|
|
|
|
Fee for service
|
CN & MN
|
|
North Carolina
|
|
No
|
|
|
|
|
|
|
North Dakota
|
|
Yes
|
$2/visit
|
|
15 visits/year
|
Fee for service
|
CN & MN
|
|
Ohio
|
|
Yes
|
|
|
4 visits/month up to 10 visits/month if services also provided on outpatient hospital basis and no more than 20 total/year, services included in limits with other specified practitioners, inpatient hospital services not covered
|
Fee for service
|
CN
|
|
Oklahoma
|
|
No
|
|
|
|
|
|
|
Oregon
|
|
Yes
|
A - $3/visit
|
Yes
|
|
Fee for service
|
A - See state-specific FN
|
|
Pennsylvania
|
|
No
|
|
|
|
|
|
|
Rhode Island
|
|
No
|
|
|
|
|
|
|
South Carolina
|
|
No
|
|
|
|
|
|
|
South Dakota
|
|
Yes
|
|
|
|
Fee for service for frequently performed services, 40% of charge up to Medicare limits for low volume procedures, supplies paid 90% of charge
|
CN
|
|
Tennessee
|
|
Yes
|
|
|
|
|
A & B - See state-specific FN
|
|
Texas
|
|
Yes
|
|
Yes
|
|
Fee for service
|
CN & MN
|
|
Utah
|
|
Yes
|
B - $3/visit
|
Yes
|
B & C - rehab potential required and16 visits/year included with limits for other specified practitioners
|
Fee for service
|
A & B - See state-specific FN
|
|
Vermont
|
|
Yes
|
|
After initial 4 months of treatment
|
|
Fee for service
|
A & B - See state-specific FN
|
|
Virginia
|
|
No
|
|
|
|
|
|
|
Washington
|
|
Yes
|
|
Yes
|
Condition specific quantity and frequency of service limits
|
Fee for service
|
CN
|
|
West Virginia
|
|
Yes
|
|
|
20 visits/year
|
Fee for service
|
CN & MN
|
|
Wisconsin
|
|
Yes
|
$.50-$3/service, depending on payment, up to 30 hours or $1,500/year across all therapies
|
Yes
|
|
Fee for service
|
CN & MN
|
|
Wyoming
|
|
Yes
|
|
|
Post-trauma/illness only, rehab potential required, 20 visits/year
|
Fee for service
|
CN
|
|
American Samoa
|
|
Yes
|
|
|
|
|
See territory-specific FN
|
|
Guam
|
|
No
|
|
|
|
|
|
|
Northern Mariana Islands
|
|
Yes
|
|
Yes
|
|
|
CN & MN - See territory-specific FN
|
|
Puerto Rico
|
|
Yes
|
|
|
15 treatments/condition/year
|
Fee for service
|
CN & MN
|
|
Virgin Islands
|
|
No
|
|
|
|
|
|
