Payer PolicyActive
Cognitive Rehabilitation and Coma Stimulation – Commercial and Individual Exchange Medical Policyopen_in_new
UHC-POL-cognitive-rehabilitation
UnitedHealthcare
Effective: October 1, 2025
Updated: December 6, 2025
created · Nov 30, 2025
Policy Summary
UnitedHealthcare covers outpatient Cognitive Rehabilitation only when medical necessity is documented per InterQual® LOC: Outpatient Rehabilitation & Chiropractic and the member-specific benefit plan allows it (inpatient CR is not covered by this policy). Coma Stimulation (multimodal sensory/coma arousal) is considered unproven and not medically necessary for any disorder of consciousness, VR-based CR has limited evidence/no established protocols, and inclusion of codes does not guarantee payment.
Coverage Criteria Preview
Key requirements from the full policy
"Outpatient Cognitive Rehabilitation (CR) services only."
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