Physical and Mental Restoration Services are those services necessary to
Examples of typical physical and mental restoration services include the following:
Prior to the provision of any physical or mental restoration service, the counselor must determine whether a comparable service or benefit is available to provide such service or cover a portion or total cost thereof.
Physical and mental restoration services are paid through the ReHabWorks system. Rules and procedures for purchasing physical restoration services can be found in the Maximum Affordable Payment Schedule (MAPS) Guidelines.
For more information, see Chapter 43: Purchasing Goods and Services for Consumers.
The purchase of counseling and psychological or psychiatric therapy is for short-term treatment or diagnosis up to (20 sessions) which impacts on the consumer's employability. Consumers who are in need of long-term treatment or therapy should be referred to their local MH/MR.
The consumer's informed choice of health professionals and appropriate facilities must be honored, unless the health professional or facility:
When selecting a hospital or ambulatory surgery center (ASC) facility for consumer-related services, work with the consumer and treating physician to select an appropriate facility for the individual's needs.
The following factors should be considered when selecting a hospital or ASC facility:
If the consumer does not know or prefer a particular hospital, ASC facility, or service provider, the counselor must provide the consumer with a listing of providers that meet the criteria listed above and allow the consumer to pick the appropriate vendor.
The purchase of eyeglasses (single vision, bifocal, or trifocal) and contact lenses requires a prescription from an ophthalmologist or optometrist.
Frames must be the least expensive serviceable type available. The consumer may supplement the additional cost for frames if their cost exceeds the MAPS maximum.
Lenses may have tint and/or be impact-resistant when specified in the prescription.
You may provide glasses if needed to complete diagnostic studies.
Before purchasing contact lenses, compare the cost of contact lenses with the cost of glasses, and apply best-value principles. See Chapter 43: Purchasing Goods and Services for Consumers.