Monthly Archives: September 2013

Therapy Gem: On Medical Necessity

Psychotherapists often hear a term, medical necessity, which is somewhat unfamiliar to them.

Some renounce the concept. “That’s for doctors.  That’s not for us.”  “We do therapy; what does “MEDICAL necessity” have to do with it?”  “We have clients, not patients.  They come in order to grow and self-actualize.”  “I only take cash clients.  So I don’t have to worry about that.”

Others treat the concept pro forma, complying superficially with the requirement.  They may write documentation which they guess will pass review by the insurance companies so the clients’ services will be covered.

Let’s take the concept seriously.  Let’s take a look at the criteria for medical necessity.  I propose turning the concept around for therapists from one to renounce or one to out-smart to one which can guide clinicians in assessment, documentation, treatment planning, and clinical responsibility.

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