Outpatient Hospital Pain Rehabilitation Programs

Outpatient hospital pain rehabilitation program services are covered when the patient's pain is due to a physical cause, conservative treatments have failed, and the pain has caused significant loss of independent function, provided services are furnished under individualized plans (group settings allowed). Explicitly non-covered items include vocational counseling, outpatient meals, and acupuncture, and Medicare contractors may deny coverage if the program is not found reasonable and necessary under §1862(a)(1).

"Patient's pain is attributable to a physical cause."

Sign up to see full coverage criteria, indications, and limitations.