CO · guidance
CO HCPF Physical and Occupational Therapy Billing Manual — Rehabilitative and Habilitative Therapy Definitions
RehabilitativeandHabilitativeTherapyDefinitions
HealthFirstColoradocoversbothrehabilitativeandhabilitativetherapiesforallagegroupsinaccordancewiththeAffordableCareActEssentialHealthBenefitprovisions.
TheColoradoDivisionofInsurancedefinedHabilitativeservicestobe:
Servicesthathelpapersonretain,learn,orimproveskillsandfunctioningfordailylivingthatareofferedinparitywith,andinadditionto,anyrehabilitativeservicesofferedinColorado'sEssentialHealthBenefitsbenchmarkplan.Parityinthiscontextmeansofliketypeandsubstantiallyequivalentinscope,amountandduration.
Rehabilitativetherapiesarethosemeanttoassistamemberwithrecoveryfromanacuteinjury,illnessorsurgicalrecovery.Habilitativetherapiesarethosemeanttohelpthememberretain,learnorimproveskillsandfunctionsfordailyliving.Thisincludesthetreatmentoflong-termchronicconditionsandmeetingdevelopmentalmilestones.
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HabilitativetherapiesarenotcategorizedasanInpatientorHomeHealthbenefit.'Acute'and'Long-term'therapiesremainbenefitsperHomeHealthcoverage.
Habilitativetherapiesarenotabenefitifprovidedinnursingfacilities;RehabilitativePT/OTremainbenefitsinthatsetting.
HabilitativetherapiesshouldnotbeconfusedwithHabilitationservicesfoundwithinHomeandCommunityBasedServices(HCBS)waivers.
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Provenance
- Source
- hcpf.colorado.gov
- Retrieved
- 2026-07-26
- Edition
- 2026-07-26
- Content hash
e8b499671ed36f520ca0cd9b7806093d20242e4f613573c9b8066df3a13d621b
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