Cognitive Rehabilitation

Aetna covers cognitive rehabilitation as adjunctive treatment for acquired cognitive deficits from moderate-to-severe traumatic brain injury, brain surgery, stroke, encephalopathy (including HIV-related encephalopathy) and postconcussion syndrome (F07.81) when criteria are met, but considers rehabilitation for behavioral/psychiatric disorders (e.g., ADHD, bipolar disorder, depression, schizophrenia, social phobia, SUD, ASD), cerebral palsy, cognitive decline in MS or COPD, dementia (Alzheimer’s, HIV, Parkinson’s), and intellectual disability experimental/investigational and not covered. Coverage requires a licensed provider acting within scope, neuropsychological testing with use of results in treatment planning, evaluation by a psychiatrist or psychologist, patient ability to actively participate and expectation of significant improvement; typical program parameters noted include ~20 one‑hour visuospatial sessions over 4 weeks and language/communication therapy ~8 hours/week beginning 4 weeks post‑onset up to 48 weeks.