Code of Massachusetts Regulations › 130 CMR - DIVISION OF MEDICAL ASSISTANCE › Title 130 CMR 430.000 - Rehabilitation Center Services › Section 430.601 - Introduction

Current through Register 1525, July 5, 2024
All rehabilitation centers participating in MassHealth must
				comply with the regulations of MassHealth, including, but not limited to
				130 CMR 430.000 and
				130 CMR 450.000.
(A)
Definitions.
(1)
Eligible Provider of
			 Rehabilitation Center Services
-- a freestanding center providing
			 rehabilitation services that is licensed by the Massachusetts Department of
			 Public Health and accredited by the Commission on Accreditation of
			 Rehabilitation Facilities (CARF).
(2)
Group Session
--
			 therapeutic services directed toward more than one patient in a single visit,
			 using group participation as a treatment technique.
(3)
Maintenance
			 Program
-- repetitive services, required to maintain or prevent
			 the worsening of function, that do not require the judgment and skill of a
			 licensed therapist for safety and effectiveness.
(4)
Occupational
			 Therapy
-- therapy services, including diagnostic evaluation and
			 therapeutic intervention, designed to improve, develop, correct, rehabilitate,
			 or prevent the worsening of functions that affect the activities of daily
			 living that have been lost, impaired, or reduced as a result of acute or
			 chronic medical conditions, congenital anomalies, or injuries. Occupational
			 therapy programs are designed to improve quality of life by recovering
			 competence, preventing further injury or disability, and to improve the
			 individual's ability to perform tasks required for independent functioning, so
			 that the individual can engage in activities of daily living.
(5)
Physical Therapy
-- therapy services, including diagnostic evaluation and therapeutic
			 intervention, designed to improve, develop, correct, rehabilitate, or prevent
			 the worsening of physical functions that have been lost, impaired, or reduced
			 as a result of acute or chronic medical conditions, congenital anomalies, or
			 injuries. Physical therapy emphasizes a form of rehabilitation focused on
			 treatment of dysfunctions involving neuromuscular, musculoskeletal,
			 cardiovascular/pulmonary, or integumentary systems through the use of
			 therapeutic interventions to optimize functioning levels .
(6)
Physician's Comprehensive
			 Rehabilitation Evaluation
-- a cardiopulmonary, neuro-muscular,
			 orthopedic, functional assessment performed at a rehabilitation center by a
			 physician.
(7)
Rehabilitation
-- the process of providing, in a
			 coordinated manner, those comprehensive services deemed appropriate to the
			 needs of a physically disabled individual, in a program designed to achieve
			 objectives of improved health and welfare with realization of his or her
			 maximum physical, social, psychological, and vocational potential.
(8)
Speech/Language
			 Therapy
-- therapy services, including diagnostic evaluation and
			 therapeutic intervention, that are designed to improve, develop, correct,
			 rehabilitate, or prevent the worsening of speech/language communication and
			 swallowing disorders that have been lost, impaired, or reduced as a result of
			 acute or chronic medical conditions, congenital anomalies, or injuries. Speech
			 and language disorders are those that affect articulation of speech, sounds,
			 fluency, voice, swallowing (regardless of presence of a communication
			 disability), and those that impair comprehension, spoken, written, or other
			 symbol systems used for communication.
(9)
Therapist's
			 Evaluation
-- an evaluation performed by a physical therapist, an
			 occupational therapist, or a speech therapist at a rehabilitation
			 center.
(10)
Therapy
			 Visit
- a personal contact with a member by a licensed physical
			 therapist, occupational therapist, or speech and language therapist for the
			 purpose of providing a covered service.