Payers will often have a specific Clinical Policy on the website listing any medical necessity requirements. Cognitive Rehabilitation specifically will often have a list of medically necessary conditions and a list of excluded conditions. When you're verifying benefits, it will be very important to verify whether it is covered for the patient's specific diagnosis.
BCBS Federal has a policy on the website stating that it may be considered medically necessary for patients with cognitive impairment due to traumatic brain injury. It is considered investigational for all other applications.
Here's a link and screenshot from that BCBS Federal policy so you have it for reference:
View attachment 7370
Some other links you may find helpful for future use:
ASHA (American Speech-Language-Hearing Association) Coding and Payment of Cognitive Evaluation and Treatment Services:
https://www.asha.org/practice/reimb...-cognitive-evaluation-and-treatment-services/
BCBS Michigan and Blue Care Network medical policy on Cognitive Rehabilitation. Specific details on the inclusions and exclusions are stated on page 2 of this PDF:
https://www.bcbsm.com/amslibs/content/dam/public/mpr/mprsearch/pdf/76784.pdf