10 Colo. Code Regs. § 2505-10-8.7531
Current through Register Vol. 47, No. 24, December 25, 2024
Section 10 CCR 2505-10-8.7531 - Massage Therapy8.7531.AMassage Therapy Eligibility1. Massage Therapy is a covered benefit available to Members enrolled in one of the following HCBS waivers:a. Children with Life Limiting Illnessb. Children's Extensive Support Waiverc. Children's Habilitation Residential Programd. Complementary and Integrative Health Waivere. Supported Living Services Waiver8.7531.BMassage Therapy Definition1. Massage Therapy means the systematic manipulation of the soft tissues of the body, (including manual techniques of gliding, percussion, compression, vibration, and gentle stretching) for the purpose of bringing about beneficial physiologic, mechanical, and psychological changes.8.7531.CMassage Therapy Inclusions1. Massage therapy shall only be used for the treatment of conditions related to the Member's illness, medical need, or behavioral need as identified on the Person-Centered Support Plan.2. Massage therapy includes the physical manipulation of muscles to ease muscle contractures or spasms, increase extension and muscle relaxation and decrease muscle tension, and WATSU.3. Massage Therapy shall be provided in a licensed massage therapist's office, an approved outpatient setting, or in the Member's residence.4. HCBS Complementary and Integrative Health Waiver (CIH); Support Living Services (SLS)a. Members receiving massage therapy services may be asked to participate in an independent evaluation to determine the effectiveness of the services.8.7531.DMassage Therapy Exclusions and Limitations1. Massage therapy is not available if it is available under the Medicaid State Plan, EPSDT or from a Third-Party Resource.2. HCBS Support Living Services (SLS) Waiver; Children's Extensive Services (CES) Waiver; Children with Life Limiting Illness (CLLI) Waiver; Children's Habilitation Residential Program (CHRP) Waiver: a. The following items are excluded and are not eligible for reimbursement:ii. Chiropractic care; andiii. Experimental treatments or therapies.3. Massage Therapy Service Limitations:a. HCBS Children with Life Limiting Illness Waiver:i. Massage Therapy shall be limited to the Member's assessed need up to a maximum of 24 hours per annual certification period.b. HCBS Complementary and Integrative Health Waiver:i. A maximum of 408 combined units of Acupuncture, Chiropractic, and Massage Therapy Waiver Services may be covered as a benefit during the support plan year.8.7531.EMassage Therapy Provider Agency Requirements1. Massage Therapy providers shall be licensed and in good standing pursuant to § 12-235-101, et seq., (C.R.S.)2. HCBS Supported Living Services (SLS) Waiver, HCBS Children's Extensive Services (CES) Waiver; Children's Habilitation Residential Program (CHRP) Waiver: a. The Medicaid State Plan therapist or physician identifies the need for the service, establishes the goal for the treatment and monitors the progress of that goal at least quarterly.3. HCBS Complementary and Integrative Health Waivera. Massage Therapy providers shall have at least year of experience practicing Massage Therapy at a rate of 520 hours per year; OR year of experience working with individuals with paralysis or other long term physical disabilities.b. Massage Therapy Provider Agencies shall: i. Determine the appropriate modality, amount, scope, and duration of the massage therapy service within the established limits at Section 8.7531.D.3.2.a.ii. Recommend only services that are necessary and appropriate in a care plan.iii. Provide only services in accordance with the Member's prior authorized units.47 CR 03, February 10, 2024, effective 3/16/202447 CR 21, November 10, 2024, effective 11/30/2024