DHS 107.19(3)(a)2.2. Be reviewed by the attending physician in consultation with the therapist providing services, at whatever intervals the severity of the recipient’s condition requires but at least every 90 days. Each review of the plan shall contain the initials of the physician and the date performed. The plan for the recipient shall be retained in the provider’s file. DHS 107.19(3)(b)(b) Restorative therapy services. Restorative therapy services shall be covered services. DHS 107.19(3)(c)(c) Maintenance therapy services. Preventive or maintenance therapy services shall be covered services only when one of the following conditions are met: DHS 107.19(3)(c)1.1. The skills and training of an audiologist are required to execute the entire preventive or maintenance program; DHS 107.19(3)(c)2.2. The specialized knowledge and judgment of an audiologist are required to establish and monitor the therapy program, including the initial evaluation, the design of the program appropriate to the individual recipient, the instruction of nursing personnel, family or recipient, and the re-evaluations required; or DHS 107.19(3)(c)3.3. When, due to the severity or complexity of the recipient’s condition, nursing personnel cannot handle the recipient safely and effectively. DHS 107.19(3)(d)(d) Evaluations. Evaluations shall be covered services. The need for an evaluation or a re-evaluation shall be documented in the plan of care. DHS 107.19(3)(e)(e) Extension of therapy services. Extension of therapy services shall not be approved in the following circumstances: DHS 107.19(3)(e)1.1. The recipient has shown no progress toward meeting or maintaining established and measurable treatment goals over a 6-month period, or the recipient has shown no ability within 6 months to carry over abilities gained from treatment in a facility to the recipient’s home; DHS 107.19(3)(e)2.2. The recipient’s chronological or developmental age, way of life or home situation indicates that the stated therapy goals are not appropriate for the recipient or serve no functional or maintenance purpose; DHS 107.19(3)(e)3.3. The recipient has achieved independence in daily activities or can be supervised and assisted by restorative nursing personnel; DHS 107.19(3)(e)4.4. The evaluation indicates that the recipient’s abilities are functional for the person’s present way of life; DHS 107.19(3)(e)5.5. The recipient shows no motivation, interest, or desire to participate in therapy, which may be for reasons of an overriding severe emotional disturbance; DHS 107.19(3)(e)6.6. Other therapies are providing sufficient services to meet the recipient’s functioning needs; or DHS 107.19(3)(e)7.7. The procedures requested are not medical in nature or are not covered services. Inappropriate diagnoses for therapy services and procedures of questionable medical necessity may not receive departmental authorization, depending upon the individual circumstances. DHS 107.19(4)(4) Non-covered services. The following services are not covered services: DHS 107.19(4)(a)(a) Activities such as end-of-the-day clean-up time, transportation time, consultations and required paper reports. These are considered components of the provider’s overhead costs and are not covered as separately reimbursable items; and DHS 107.19 NoteNote: For more information on non-covered services, see s. DHS 107.03. DHS 107.19 HistoryHistory: Cr. Register, February, 1986, No. 362, eff. 3-1-86; am. (1) (b), (c) and (h), (2) (a) 1. and 3., Register, May, 1990, No. 413, eff. 6-1-90; corrections in (1) (intro.) and (4) (b) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636. DHS 107.20(1)(1) Covered services. Covered vision care services are eyeglasses and those medically necessary services provided by licensed optometrists within the scope of practice of the profession of optometry as defined in s. 449.01, Stats., who are certified under s. DHS 105.32, and by opticians certified under s. DHS 105.33 and physicians certified under s. DHS 105.05. DHS 107.20(2)(2) Services requiring prior authorization. The following covered services require prior authorization by the department: DHS 107.20(2)(a)(a) Vision training, which shall only be approved for patients with one or more of the following conditions: DHS 107.20(2)(b)(b) Aniseikonic services for recipients whose eyes have unequal refractive power;