- (l) The department covers inpatient chronic pain management services only when the services are obtained through a department-approved chronic pain facility.
(2) A client qualifies for inpatient chronic pain management services when all of the following apply:
- (a) The client has had chronic pain for at least three months, that has not improved with conservative treatment, including tests and therapies;
- (b) At least six months have passed since a previous surgical procedure was done in relation to the pain problem; and
- (c) Clients with active substance abuse must have completed a detoxification program, if appropriate, and must be free from drugs or alcohol for six months.
- (3) For chronic pain management, the department limits coverage to only one inpatient hospital stay per client's lifetime, up to a maximum of twenty-one days.
- (4) The department reimburses for only the chronic pain management services and procedures that are listed in the fee schedule.
[WSR 11-14-075, recodified as § 182-531-0700, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. WSR 10-19-057, § 388-531-0700, filed 9/14/10, effective 10/15/10. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 01-01-012, § 388-531-0700, filed 12/6/00, effective 1/6/01.]