(1) Pain and symptom management is defined as a service that provides traditional and nontraditional methods of pain reduction or management.

(2) Allowable non-traditional or mind-body therapies include:

(a) acupuncture;

(b) reflexology;

(c) massage therapy;

(d) craniosacral therapy;

(e) hypnosis;

(f) biofeedback; and

(g) pain mitigation counseling/coaching.

(3) Allowable traditional therapies include:

(a) chiropractic therapy; and

(b) nursing services by a nurse specializing in pain and symptom management.

(4) The service must be prescribed by a licensed health care professional.

(5) The service must be documented in the member's Person-Centered Recovery Plan and:

(a) address the member's chronic or acute symptoms, complaints, or complications indicating the need for services;

(b) include the number of authorized sessions; and

(c) document the expected outcomes of the provision of the service.

(6) Services must be provided by a person licensed or certified to provide the service.