Medicare Guidelines For Physical Therapy

CMS Revises Interpretive Guidelines Regarding Rehab Referrals

The Centers for Medicare and Medicaid Services (CMS), Baltimore, has revised its interpretive guidelines (Transmittal 72) to eliminate the requirement that rehabilitation services furnished in outpatient hospital settings be ordered by a practitioner with medical staff privileges, according to the American Physical Therapy Association (APTA), Alexandria, Va. This amendment reportedly came in response to concerns raised by APTA and other associations.

The new guidance states that outpatient services in hospitals may be ordered—and patients may be referred for hospital outpatient services—by a practitioner who is responsible for the care of the patient and licensed in, or holds a license recognized in, the jurisdiction where he or she sees the patient. In addition, the practitioner must be acting within his or her scope of practice under state law and authorized by the medical staff to order the applicable outpatient services under written hospital policy that is approved by the governing body. 

The last requirement includes both practitioners who are on the hospital medical staff and who hold medical staff privileges such as ordering the services. Other practitioners who are not on the hospital medical staff, but who satisfy the hospital’s policies for ordering applicable outpatient services and for referring patients for hospital outpatient services also fall under this category.

The hospital’s medical staff policy for authorizing practitioners to refer patients for outpatient services must address how the hospital verifies that the referring practitioner who is responsible for the patient’s care is appropriately licensed and acting within his or her scope of practice. 

These new requirements were issued to the State Survey Agency Directors on February 17 and are effective immediately. APTA says the Survey and Certification Policy Memorandum will be available on the CMS Web site next week.

Medicare Guidelines For Physical Therapy - News


AquaHab Physical Therapy Implements Policy Changes and Flexible Treatment ...

20, 2012 /PRNewswire via COMTEX/ -- As healthcare costs continue to rise, AquaHab Physical Therapy has implemented new policies and practices to ensure that treatments remain affordable for patients. The multi-clinic practice, which offers both



CMS Revises Interpretive Guidelines Regarding Rehab Referrals

The Centers for Medicare and Medicaid Services (CMS), Baltimore, has revised its interpretive guidelines (Transmittal 72) to eliminate the requirement that rehabilitation services furnished in outpatient hospital settings be ordered by a practitioner



Coalition to Congress: Protect Seniors By Protecting Therapy Services

By American Occupational Therapy Association WASHINGTON, Feb. 15, 2012 /PRNewswire-USNewswire/ -- Advocating on behalf of hundreds of thousands of Medicare beneficiaries who receive outpatient rehabilitation services every year, the Therapy Cap



Stemming the tide of overtreatment in US healthcare

Medicare data show that doctors often order MRI scans for patients with lower back pain who have not tried less invasive, less expensive treatments such as physical therapy. An MRI frequently leads to surgery, data show. One study by the National



Stemming overtreatment in US healthcare may cut costs of care

Medicare data show that doctors often order MRI scans for patients with lower back pain who have not tried less invasive, less expensive treatments such as physical therapy. An MRI frequently leads to surgery, data show. One study by the National




Medicare Guidelines For Physical Therapy - Bookshelf

The Hug Therapy Book

The Hug Therapy Book

Argues that embraces contribute to our physical and mental well-being and describes the finer points of therapeutic hugging

Social Security, Medicare & Government Pensions, Get the Most Out of Your Retirement & Medical Benefits

Social Security, Medicare & Government Pensions, Get the Most Out of Your Retirement & Medical Benefits

Navigate the complex and often daunting Social Security and Medicare systems using the resources and information in this complete guide.

The Case for Christ, A Journalist's Personal Investigation of the Evidence for Jesus

The Case for Christ, A Journalist's Personal Investigation of the Evidence for Jesus

Does evidence exist for Jesus outside the Bible? Is there any reason to believe the resurrection was an actual event? Strobel's tough, point-blank questions make this remarkable book read like a captivating, fast-paced novel.

Man's Search for Meaning

Man's Search for Meaning

Viennese psychiatrist tells his grim experiences in a German concentration camp which led him to logotherapy, an existential method of psychiatry.

Heaven is for Real, A Little Boy's Astounding Story of His Trip to Heaven and Back

Heaven is for Real, A Little Boy's Astounding Story of His Trip to Heaven and Back

02