Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines (MAC)
This communication applies to Commercial and Medicare Advantage plans from Anthem Blue Cross and Blue Shield (Anthem).
Effective for dates of service on and after April 9, 2023, the following updates will apply to the AIM Specialty Health®* Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines. As part of the AIM guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe, and affordable healthcare services.
Rehabilitative and habilitative services — updates by section
- Clarified language about the background of speech-language professionals
- Clarified language about qualified speech-language pathology providers
Speech therapy alternative treatments:
- Clarified language about qualified speech providers
- Definition of blue dye test clarified
- Parkinson Voice Project definition expanded
Physical therapy and occupational therapy adjunctive treatments:
- Added definition of Lee Silverman Voice Treatment BIG — proprietary program of intensive physical and/or occupational therapy of at least one month duration involving large, full-body exercises to improve functional movement and self-care tasks of people with Parkinson’s disease and other neurological conditions. It requires company-certification of providers.
- Added exclusion for Lee Silverman Voice treatment
As a reminder, ordering and servicing providers may submit prior authorization requests to AIM:
- Access AIM’s ProviderPortalSM directly at providerportal.com:
- Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization.
If you have questions related to guidelines, please contact AIM via email at firstname.lastname@example.org. Additionally, you may access and download a copy of the current and upcoming guidelines here.
January 2023 Anthem Provider News - Georgia