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INDIVIDUAL COMPREHENSIVE TREATMENT PLAN

Tag No.: B0118

PLAN INCLUDES SPECIFIC TREATMENT MODALITIES UTILIZED

Tag No.: B0122

PLAN INCLUDES RESPONSIBILITIES OF TREATMENT TEAM

Tag No.: B0123

PLAN INCLUDES ADEQUATE DOCUMENTATION TO JUSTIFY DIAGNOSIS

Tag No.: B0124

TREATMENT DOCUMENTED TO ASSURE ACTIVE THERAPEUTIC EFFORTS

Tag No.: B0125

MONITOR/EVALUATE QUALITY/APPROPRIATENESS OF SERVICES

Tag No.: B0144

PARTICIPATES IN FORMULATION OF TREATMENT PLANS

Tag No.: B0148