Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter II - Specific Policies By Service
Section 144-101-II-85 - MaineMOM Services and Reimbursement
Subsection 144-101-II-85.02 - DEFINITIONS

85.02-1 Functionally Significant Improvement: demonstrable, measurable increase in the member's ability to perform specific tasks or motions that contributes to independence outside the therapeutic environment.

85.02-2 Long-Term Chronic Pain: any pain that has lasted or is expected to last more than sixty (60) days and impacts and is expected to impact a member's level of function for more than 60 days.

85.02-3 Maintenance Care: physical therapy services provided to a member whose condition is stabilized after a period of treatment or for whom no further functionally significant improvement is expected.

85.02-4 Pain Management Care Plan: a plan of care ordered by a rendering provider or consulting provider including the use of at least one therapeutic treatment option.

85.02-5 Physical Therapy Practitioner: an individual who is licensed as a Physical Therapist or licensed as a Physical Therapy Assistant working under the supervision of a licensed Physical Therapist.

85.02-6 Physical Therapy Services: the evaluation, treatment and instruction of human beings to detect, assess, prevent, correct, alleviate and limit physical disability, bodily malfunction and pain from injury, disease and any other bodily condition; the administration, interpretation and evaluation of tests and measurements of bodily functions and structures for the purpose of treatment planning includes the planning, administration, evaluation and modification of treatment and instruction; and the use of physical agents and procedures, activities and devices for preventive and therapeutic purposes; and the provision of consultative, educational and other advisory services for the purpose of reducing the incidence and severity of physical disability, bodily malfunction and pain.

85.02-7 Practitioner of the Healing Arts: Physicians and all others registered or licensed in the healing arts, including, but not limited to, nurse practitioners, podiatrists, optometrists, chiropractors, physical therapists, occupational therapists, speech therapists, dentists, psychologists and physicians' assistants.

85.02-8 Rehabilitation Potential: documented expectation of measurable functionally significant improvement in the member's condition in a reasonable, predictable period of time as the result of the prescribed treatment plan.

85.02-9 Terminal Illness: is a medical condition resulting in a prognosis that a member has a life expectancy of six (6) months or less if the illness runs its normal course.