Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy

This brochure version is for internal use only.

2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy

Note: We state whether or not the calendar year deductible applies for each benefit listed in this section.

Benefit Description

Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy
Outpatient treatment therapies, subject to visit limits:

Physical therapy, occupational therapy, and speech therapy:
- Benefits are limited to 25 visits per person, per calendar year for physical, occupational, or speech therapy, or a combination of all three; regardless of the provider or facility billing for the services
Cognitive rehabilitation therapy, limited to 25 visits per calendar year, regardless of the provider billing the service

You Pay
Preferred: $25 copayment per visit (no deductible)

Non-preferred (Participating/Non-participating): You pay all charges

Notes:

You pay 30% of the Plan allowance (deductible applies) for agents, drugs, and/or supplies administered or obtained in connection with your care. (See page 128 for more information about “agents.”)
See Section 5(c) for our payment levels for rehabilitative therapies billed for by the outpatient department of a hospital.

Benefit Description

Not covered:

Recreational or educational therapy, and any related diagnostic testing except as provided by a hospital as part of a covered inpatient stay
Maintenance or palliative rehabilitative therapy
Exercise programs
Hippotherapy/Equine therapy
Massage therapy

You Pay
All charges