Habilitative vs Rehabilitative Therapy

Many insurance carriers, including many state Medicaid programs, have different outpatient therapy benefit coverage dependent upon whether the therapy is rehabilitative in nature or habilitative in nature. In addition, some insurance carriers are requiring a modifier be reported on the claim form to indicate if the therapy provided was rehabilitative or habilitative. In this article, I will explain the difference between habilitative therapy and rehabilitative therapy and discuss the new modifier that some insurance carriers are requiring when providing habilitative therapy services.