Page 43

STATE CHILD HEALTH PLAN UNDER TITLE XXI OF THE SOCIAL SECURITY ACT

STATE: Virginia Page 6-43

Effective Date: 07/01/05

43 Approval Date: _____________/06 only be performed by a physical therapist licensed by the Board of Medicine or a physical therapy assistant who is licensed by the Board of Medicine and under the supervision of a qualified physical therapist who makes an onsite supervisory visit at least once every 30 days. This visit shall not be reimbursable. C. Occupational therapy: Services for individuals requiring occupational therapy are provided only as an element of hospital inpatient or outpatient service, nursing facility service, home health service, or when otherwise included as an authorized service by a provider who provides rehabilitation services. Services shall meet all of the following conditions: services shall be directly and specifically related to an active written plan of care designed by a physician after consultation with an occupational therapist registered and certified by the American Occupational Therapy Certification Board; shall be of a level of complexity and sophistication, or the condition of the patient shall be of a nature that the services can only be performed by a qualified occupational therapist. The amount, frequency and duration of the services shall be reasonable. D. Services for individuals with speech, hearing and language disorders. Services must be provided by or under the supervision of a speech pathologist or an audiologist only as an element of hospital inpatient or outpatient service, nursing facility service, home health service, or when otherwise included as an authorized service by a cost provider who provides rehabilitative services. Services shall be directly and specifically related to an active written treatment plan designed by a physician after any needed consultation with a speech-language pathologist licensed by the Board of Speech/Language Pathology, or, if exempt from state licensure, meets the requirements in 42 CFR 405.1719(c). The services shall be of a level of complexity and sophistication or the patient’s condition be of a nature that the services can only be performed by or under the direction of a qualified speech- language pathologist. The amount, frequency and duration of the services shall be reasonable.

6.2.23.A ⌧ Hospice care (Section 2110(a)(23)) A. Defined as those services allowed under the provisions of Medicare law and regulations as they relate to hospice benefits and as specified in the Code of Federal Regulations, Title 42, Part 418. Hospice services shall entail the following four categories of daily care: 1. Routine home care (at-home care that is not continuous). 2. Continuous home care consists of at-home care that is