Table 2. Coverage and Utilization Management for Nonpharmacologic Pain Therapies in 15 Medicaid Plans .
Pain Therapy | No. of Plans | ||||||
---|---|---|---|---|---|---|---|
Coverage | Utilization Management | ||||||
Covered | Unclear or Not Found | Not Covered | Prior Authorization | Condition Requirements | Visit Limits | Referral Requirements | |
Rehabilitative therapies | |||||||
Physical therapy | 14 | 1 | 0 | 4 | 2 | 14 | 10 |
Occupational therapy | 14 | 1 | 0 | 3 | 3 | 14 | 10 |
Chiropractic care | 12 | 2 | 1 | 1 | 9 | 11 | 1 |
Acupuncture | 2 | 5 | 8 | 1 | 1 | 1 | 0 |
Therapeutic massage | 1 | 10 | 4 | 1 | 1 | 1 | 0 |
Psychological interventions | 3 | 12 | 0 | 0 | 0 | 0 | 0 |
Transcutaneous electrical nerve stimulation | 10 | 5 | 0 | 7 | 1 | 2 | 3 |
Injections | |||||||
Steroid | 9 | 6 | 0 | 3 | 1 | 3 | 0 |
Facet | 7 | 8 | 0 | 2 | 1 | 1 | 0 |
Back surgery | |||||||
Laminectomy | 3 | 12 | 0 | 1 | 0 | 0 | 0 |
Diskectomy | 2 | 13 | 0 | 1 | 0 | 0 | 0 |