| Acupuncture - (CPG024) |
PDF |
637kB |
04/15/2025 |
| Axial/Spinal Decompression Therapy/Mechanical Traction (Provided in a Clinic Setting) - (CPG275) |
PDF |
414kB |
04/15/2025 |
| Biofeedback - (CPG294) |
PDF |
675kB |
11/15/2024 |
| Biofeedback - (CPG 294) ---- future effective policy |
PDF |
658kB |
09/15/2025 |
| Cardiac Rehabilitation (Phase II Outpatient) - (0073) |
PDF |
361kB |
05/15/2025 |
| Chiropractic Care - (CPG278) |
PDF |
524kB |
12/15/2024 |
| Cognitive Rehabilitation - (CPG270) |
PDF |
554kB |
07/15/2025 |
| Complex Lymphedema Therapy (Complete Decongestive Therapy) - (CPG157) |
PDF |
493kB |
05/15/2025 |
| Electric Stimulation for Pain, Swelling and Function in a Clinic Setting - (CPG272) |
PDF |
804kB |
08/15/2025 |
| Electrodiagnostic Testing (EMG/NCV) - (CPG129) |
PDF |
928kB |
09/15/2024 |
| Home Traction Devices - Cervical and Lumbar - (CPG265) |
PDF |
338kB |
04/15/2025 |
| Low-Level Laser and High-Power Laser Therapy - (CPG030) |
PDF |
670kB |
03/15/2025 |
| Occupational Therapy - (CPG155) |
PDF |
576kB |
12/15/2024 |
| Occupational Therapy - (CPG155) ---- future effective policy |
PDF |
595kB |
09/15/2025 |
| Patient Assessments: Medical Necessity Decision Assist Guideline for Evaluations and Re-evaluations - (CPG111) |
PDF |
380kB |
07/15/2025 |
| Physical Performance Test or Measurement - (CPG295) |
PDF |
324kB |
11/15/2024 |
| Physical Therapy - (CPG135) |
PDF |
613kB |
12/15/2024 |
| Physical Therapy - (CPG135) ---- future effective policy |
PDF |
635kB |
09/15/2025 |
| Range of Motion Testing - (CPG146) |
PDF |
274kB |
06/15/2025 |
| Sensory and Auditory Integration Therapy - Facilitated Communication - (CPG149) |
PDF |
414kB |
06/15/2025 |
| Site of Care: Outpatient Hospital Setting for Physical and Occupational Therapy - (0600) |
PDF |
187kB |
10/01/2025 |
| Spinal Ultrasound - (CPG038) |
PDF |
315kB |
09/15/2024 |
| Strapping and Taping - (CPG143) |
PDF |
737kB |
05/15/2025 |