RESTORATION (Treatment of Impairments)

Restoration (physical or mental) includes corrective surgery or therapeutic treatment that is likely, within a reasonable period of time, to correct or modify substantially a stable or slowly progressive physical or mental impairment that constitutes a substantial impediment to employment.
NOTE: Devices provided to improve or maintain the individual’s ability to function would be recorded under Assistive Technology Devices.

Physical Restoration

200 Health insurance payments
Time-limited or partial payments for client’s health insurance coverage are allowed. The rationale for the need, cost-effectiveness and contribution to the employment outcome must be clearly documented in the record of services.
Examples:
Medical insurance premium
Working Healthy premium
Health insurance payment

210 Drugs and supplies
Includes medication prescribed by a qualified source and related supplies. Over the counter medication must also be prescribed by a qualified source.
Examples:
Co-pay for prescription
Diabetic testing supplies
Insulin
Non-prescription medication
Over-the-counter medication
Pharmacy supplies
Pill dispenser
Prescription medication
Syringes

220 Surgery (surgeons’ fees)
Corrective surgery that is likely, within a reasonable period of time, to correct or modify an impairment that constitutes a substantial impediment to employment.
Note that other services, such as hospitalization, anesthesia and radiology are frequently associated with surgery and coded separately.
Examples:
Assistant surgeon charge
Cataract surgery
Chemotherapy
Dialysis
Laser surgery
Pain management treatment
Surgeon fees

230 Anesthesia
Examples:
Anesthesiologist fee
Anesthesiology charge

240 Medical Treatment (office visits and rechecks)
Examples:
Follow-up eye exam
Follow-up visit with Dr
Physician's office visit
Recheck

245 Intercurrent illness treatment
An unexpected illness or injury that arises during rehabilitation and constitutes a hazard to the determination of eligibility, participation in IPE services or the achievement of the vocational objective.
Examples:
Treatment for a broken bone
Treatment of flu
Appendectomy

250 Hospital Care (inpatient or outpatient)
Necessary hospitalization in connection with surgery or treatment.
Examples:
Emergency room charge
Hospital fee
Inpatient fee
Inpatient care
Outpatient hospitalization
Recovery room charges
Room charges
Surgery hospital supplies
Surgical care

260 Chiropractic Services
Example:
Chiropractor fees

280 Dental services (not devices)
Examples:
Crown
Dental exam
Dental services
Fillings
Orthodontic repairs
Root canal
Teeth cleaning
Tooth extraction

350 Physical & Occupational therapy
Examples:
Occupational therapy
Physical therapy
Therapeutic exercise
Electrical stimulation

360 Speech/Hearing Therapies
Examples:
Audiological training
Phonetics training
Speech evaluation
Speech therapy

Mental Restoration

320 Psychiatric Treatment
Treatment for mental and emotional disorders by a psychiatrist.
Examples:
Psychiatric medication check
Psychiatric services
Psychiatric therapy sessions
Psychiatric treatment

330 Alcohol/Drug services
Examples:
Addiction treatment
Alcohol/Drug treatment
Drug screening/urinalysis
Recovery services

340 Psychological Services
Treatment for mental and emotional disorders provided by a qualified psychologist, social worker or other qualified provider.
Examples:
Counseling sessions
Group therapy
Individual therapy
Mental health center services
Psychotherapy (other than psychiatrist)

RELATED INFORMATION FOR RESTORATION
· Fee schedule applies to specific services.
· In-patient alcohol/drug treatment is limited to a maximum of 25 days.
· The Counselor's spending authority (cost cap) for the treatment of an intercurrent illness is $6,750 for the life of the case. See Section 3 / Part 8 for additional information.
· Specific conditions apply to the provision of surgery. See Section 4 / Part 11.