All PlansCoverageMedium impact
Cognitive Rehabilitation
Blue Cross & Blue Shield of Mississippi·MS · Neurology, PM&R (Physical Medicine & Rehab), Physical Therapy +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their cognitive rehabilitation policy to only cover services for moderate to severe traumatic brain injury patients when strict criteria are met. All other conditions including mild TBI, stroke, Alzheimer's, MS, and COVID-related cognitive issues are now considered investigational and not covered.
Action Required
Immediately: Billing team must update cognitive rehabilitation billing to only submit claims for moderate to severe TBI patients who meet ALL coverage criteria (qualified licensed professional, physician prescription, written care plan, adequate cognitive function, demonstrated improvement). Stop billing cognitive rehabilitation for mild TBI, stroke, Alzheimer's, MS, COVID cognitive issues, and cancer-related cognitive deficits as these are now investigational. Verify all cognitive rehab claims have physician documentation of medical necessity and treatment plan.