Utilization Review

Physical and Occupational Therapy Treatment Window

WSI allows a window period for physical and occupational therapy treatment of each new claim. A new window period is not allowed if the patient changes therapists during treatment.

• The window period for initial care and post-operative care is 10 visits or 60 days of care, whichever comes first
• Therapy for post-op must begin within 90 days after surgery date
• One initial window period per claim, not per body part or diagnosis
• Modalities are limited to two per visit
• For extension of timeframe on prior approved therapy sessions call the UR department before approval expires
• Time extensions do not apply to initial window period
• Window period expires 60 days from initial evaluation