Inpatient Hospital Pain Rehabilitation Programs

Inpatient hospital pain rehabilitation is covered when pain has a documented physical cause, conservative treatments have failed, and the pain has produced a significant loss of independent function; coverage requires a coordinated, multidisciplinary hospital-level program. Programs are generally expected to run about 4 weeks with a 7–10 day evaluation period; excluded services (e.g., acupuncture, dorsal column stimulators, family counseling) and cases where pain is primarily psychiatric are not covered. Documentation must justify use of covered services only, show diagnostic tests are related and non-duplicative, and substantiate any inpatient care beyond four weeks.

"An inpatient hospital stay for participation in a pain rehabilitation program is covered when the pain is attributable to a physical cause, usual methods of treatment have not successfully alleviat..."