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Medical Necessity Definition
ENDORSEMENT
Approved by the Board of Trustees, October 2000
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"Policy documents are approved by the APA Assembly and Board of Trustees… These are …position statements that define APA official policy on specific subjects…" -- APA Operations Manual. |
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The American Psychiatric Association endorses the statement from the American Medical Association which defines “medical necessity” as:
“… services or products that a prudent physician would provide to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, or its symptoms in a manner that is: (1) in accordance with generally accepted standards of medical practice; (2) clinically appropriate in terms of type, frequency, extent, site, and duration; and (3) not primarily for the convenience of the patient, physician, or other health care provider. “
The current version of the AMA Policy Statement, H-320.953 –
Definitions of "Screening" and "Medical Necessity" (CMS Rep. 13, I-98; Modified: Res. 703, A-03) can be found online at the AMA PolicyFinder:
http://www.ama-assn.org/ama/noindex/category/11760.html