Medicaid Documentation Guidelines for Rehabilitative Services: Assessment

Module Four

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• Introduction*
• Diagnostic Assessment*
• Crisis Assessment *
• Functional Assessment*
• Interpretive Summary*
• Challenge*

Summary

The assessment process for rehabilitation is multi-faceted and includes a person’s perspective, diagnostic assessment, functional assessment, level of care, and an interpretive summary that integrates all information in a meaningful way.

The assessment processes must document:

• medical necessity for rehabilitation
• eligible diagnosis
• functional impact of the diagnosis
• interference with the client’s goals
• client clearly meets the admissions criteria for this level of care