Non-Covered Physical Therapy Services

This policy addresses coverage of physical therapy services and specific modalities/devices, identifying many techniques and equipment (for example, spray‑and‑stretch, fluidotherapy, mechanical massage/spinal mobilization, craniosacral therapy, ROMTech devices, hydrocollators, kinesiology/taping, cupping and other special exercise equipment) as non‑covered, experimental, or not medically necessary. Coverage decisions depend on the member’s benefit plan/contract and state regulations — with a narrow Illinois exception allowing certain therapy for insured children with neuromuscular/neurological/cognitive impairments effective 1/1/2025 — and it excludes maintenance or convenience services, duplicate PT/OT, unauthorized equipment rental/purchase, and other modalities lacking proven benefit (policy transitions to THE803.010 for services on/after 2026‑01‑01).

"Illinois (exception): Coverage for therapy, diagnostic testing, and equipment necessary to increase quality of life for children clinically or genetically diagnosed with any disease, syndrome, or d..."