NIA - Clinical Guidelines

Clinical Guidelines

This Clinical Guideline has been developed in accord with medical necessity criteria contained in Hawaii's Patients' Bill of Rights and Responsibilities Act (Hawaii Revised Statutes §432E-1.4), generally accepted standards of medical practice. If a treating physician disagrees with NIA's determination as to medical necessity in a given case, the physician may request that HMSA reconsider the application of the medical necessity criteria to the case at issue in light of any supporting documentation.

Florida Blue Medicare requests have specific guidelines for services rendered in state. For these services, please use one of the following links:

Physical Medicine Solutions

Click here to view NIA’s Physical Medicine guidelines.
Magellan adopted the use of MCG Guidelines® for its Physical Medicine product. View instructions for accessing MCG Guidelines®.