A documented treatment plan that outlines the patient's diagnosis, functional limitations, treatment goals, interventions, frequency, and expected duration of therapy.
A CMS requirement for reporting functional limitations and therapy outcomes using standardized G-codes and severity modifiers on Medicare claims.
The clinical justification that a healthcare service is reasonable and necessary for the diagnosis or treatment of a patient's condition.
A requirement by insurance companies for providers to obtain approval before delivering certain services, ensuring the services are medically necessary and covered under the patient's plan.
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