Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 213 - Therapy Services
Chapter 1 - Physical Therapy
Rule 23-213-1.9 - Beneficiary Non-Compliance
Universal Citation: MS Code of Rules 23-213-1.9
Current through September 24, 2024
Medicaid does not cover therapy services when documentation supports that the beneficiary:
A. Has not reached therapy goals and is unable to participate and/or benefit from skilled intervention,
B. Refuses to participate, or
C. Is otherwise noncompliant with the therapy regimen. Medicaid defines noncompliance as failure to follow therapeutic recommendations which may include any or all of the following:
1. Failure to attend scheduled
therapy sessions, which is defined by Medicaid as cancellation or no show' to
three (3) consecutive therapy sessions and/or missing half or more of the
scheduled visits without documentation of valid reasons such as personal
illness/hospitalization or illness/death in the family,
2. Failure to perform home exercise program
as instructed by the therapist,
3.
Failure to fully participate in therapy sessions,
4. Failure of the parent/caregiver to attend
therapy sessions with beneficiary who is incapable of carrying out the home
program without assistance,
5.
Failure to properly use special equipment or adaptive devices, or
6. Failure of parent/caregiver/beneficiary to
otherwise comply with therapy regimen as documented in the medical
record.
Miss. Code Ann. § 43-13-121
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
