Outpatient hospital-based physical therapy and occupational therapy services (site-of-care)
Defines medical necessity criteria for provision of physical therapy (PT) and occupational therapy (OT) in an outpatient hospital setting for adult and pediatric patients, when hospital-based site of care is required instead of freestanding PT/OT facilities.
New Policy created effective 10/1/2025
Coverage Summary
This policy defines medical necessity criteria for provision of physical therapy (PT) and occupational therapy (OT) in an outpatient hospital setting and is applied to both adult and pediatric patients. Coverage stance: covered_with_criteria.
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