Therapy recertification & MD visits: Does the patient have to see the doctor every 30 days in order to continue therapy?
CMS Publication 100-2, the Medicare Benefit Policy Manual, Chapter 15, Section 220.1.3, subsection C, addresses this question under “Physician/NPP options for Certification.” It states: (via this link: http://www.cms.hhs.gov/manuals/Downloads/bp102c15.pdf) “Physicians/NPPs (non-physician practitioners) may require that the patient make a visit for an examination if, in the professional’s judgment, the visit is needed prior to certifying the plan. Physicians/NPPs should indicate their requirement for visits, preferably on an order preceding the treatment, or on the plan of care. Physicians/NPPs should not sign a certification if they require a visit and a visit was not made. However, Medicare does not require a visit unless the National Coverage Determination (NCD) for a particular treatment requires it (e.g., see Pub. 100-03, 270.1 – Electrical Stimulation (ES) and Electromagnetic Therapy for the Treatment of Wounds).
Related Questions
- If a patient receives home physical therapy prior to outpatient therapy services, do the home therapy visits count towards the amount of physical therapy that is recommended in the Guidelines?
- Therapy recertification & MD visits: Does the patient have to see the doctor every 30 days in order to continue therapy?
- Does the patient have to see the doctor every 30 days in order to continue therapy?
