Health Information Management

Q/A: Physical and occupational therapy in the outpatient department

APCs Insider, July 31, 2009

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Q: What are the guidelines for physician supervision for physical therapy/occupational therapy and speech therapy provided in a hospital outpatient department?
 
A: Physical therapy and occupational therapy are covered under their own basis of coverage, separate from the “incident to” coverage provision, under the Social Security Act and therefore are not subject to the limitations for coverage for other therapeutic service “incident to” a physician’s service that are proposed to be changed for 2010. For a discussion of the requirements for physical therapy and occupational therapy please see the Benefit Policy Manual, Chapter 15, beginning at Section 220. Be sure to also review National Coverage Determinations that apply to many specific therapy services.



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