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
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