Post-acute rehabilitation residential services for traumatic brain injury (TBI) are authorized based on a tiered rate structure. Each tier represents a preauthorized number of hours for core therapy services. A week is defined as Sunday through Saturday.
The initial tier level is Tier 2, not to exceed 14 hours per week. Once assessments are complete, the tier, with prior authorization, may be changed to the tier recommended on a weekly basis by the interdisciplinary team (IDT). Supporting documentation must include information relating to a consumer’s needs, goals, and recommended core therapy services.