Re: Plan of Care Certifications

[Guest guest]

Who provided this course? This has never been the case, and in fact I've seen

indications that the therapist's responsibility for the plan of care is being

recognized by CMS.

Melinda Nygren Pierce, PT, MS

Director of Rehabilitation

Presbyterian Homes

3200 Grant Street

ton, IL 60201

" Working to encourage older

adults to experience fullness

of life in community with dignity,

joy and the maximum level of

independence their health will allow. "

>>> Westberg 12/16/2008 4:27 PM >>>

Dear listserve,

I recently had a discussion with a fellow PT who took a course regarding new

Medicare billing requirements. He stated, and a review of the handout/audio CD

confirmed that the presenter stated the following very clearly;

The Plan of Care must come from the referring MD, NOT from the evaluating PT.

In other words obtaining a prescription for PT such as LBP, eval and treat, with

the MD's signature below, then following up with the POC for signature, and

obtaining that signature is no longer sufficient?

This is in direct contrast to my understanding at this time. It would be

difficult to at best to

obtain this from MD's and just seems over the top.

I am hoping this presenter is wrong and would like to get the opinion of the

forum on this matter.

Sincerely,

Westberg, PT

Chicago, IL

[Guest guest]

Melinda,

I would say your interpretation is more accurate.

The physician delegates the actual writing of the Plan of Care

(POC)(including examination, evaluation, diagnosis and prognosis) to

the physical therapist.

The physical therapist then obtains the physician signature on the

written POC and implements treatment.

My source is Transmittal 88 (page 15), as follows:

" Outpatient therapy services shall be furnished under a plan

established by(one of the following):

A physician/NPP (consultation with the treating physical therapist,

occupational therapist, or speech-language pathologist is recommended.

Only a physician may establish a plan of care in a CORF);

The physical therapist who will provide the physical therapy services;

The occupational therapist who will provide the occupational therapy

services; or

The speech-language pathologist who will provide the speech-language

pathology services.

The plan may be entered into the patient's therapy record either by

the person who established the plan or by the provider's or supplier's

staff when they make a written record of that person's oral orders

before treatment is begun. "

It sounds like the audio CD may have been taken out of context.

Tim , PT

www.BulletproofPT.com

>

> Who provided this course? This has never been the case, and in fact

I've seen indications that the therapist's responsibility for the plan

of care is being recognized by CMS.

>

> Melinda Nygren Pierce, PT, MS

> Director of Rehabilitation

> Presbyterian Homes

> 3200 Grant Street

> ton, IL 60201

>

>

> " Working to encourage older

> adults to experience fullness

> of life in community with dignity,

> joy and the maximum level of

> independence their health will allow. "

>

>

> >>> Westberg 12/16/2008 4:27 PM >>>

>

> Dear listserve,

>

> I recently had a discussion with a fellow PT who took a course

regarding new Medicare billing requirements. He stated, and a review

of the handout/audio CD confirmed that the presenter stated the

following very clearly;

> The Plan of Care must come from the referring MD, NOT from the

evaluating PT. In other words obtaining a prescription for PT such as

LBP, eval and treat, with the MD's signature below, then following up

with the POC for signature, and obtaining that signature is no longer

sufficient?

>

> This is in direct contrast to my understanding at this time. It

would be difficult to at best to

> obtain this from MD's and just seems over the top.

>

> I am hoping this presenter is wrong and would like to get the

opinion of the forum on this matter.

>

> Sincerely,

>

> Westberg, PT

> Chicago, IL

>

>

[Guest guest]

In all settings except a CORF, the PT, OT, or SLP may

establish the plan of care. That plan of care is then

sent to the physician or non-physician practitioner

for their signature certifying the need for the

therapy services as detailed in the POC established by

the therapist.

The reference for this is CMS Pub 100-02, Chapter 15,

Section 220.1.2. Begin reading on page 156 of the link

below.

http://www.cms.hhs.gov/manuals/Downloads/bp102c15.pdf

Rick Gawenda, PT

President/CEO

Gawenda Seminars

www.gawendaseminars.com

--- Melinda Pierce

wrote:

> Who provided this course? This has never been the

> case, and in fact I've seen indications that the

> therapist's responsibility for the plan of care is

> being recognized by CMS.

>

> Melinda Nygren Pierce, PT, MS

> Director of Rehabilitation

> Presbyterian Homes

> 3200 Grant Street

> ton, IL 60201

>

>

> " Working to encourage older

> adults to experience fullness

> of life in community with dignity,

> joy and the maximum level of

> independence their health will allow. "

>

>

> >>> Westberg 12/16/2008

> 4:27 PM >>>

>

> Dear listserve,

>

> I recently had a discussion with a fellow PT who

> took a course regarding new Medicare billing

> requirements. He stated, and a review of the

> handout/audio CD confirmed that the presenter stated

> the following very clearly;

> The Plan of Care must come from the referring MD,

> NOT from the evaluating PT. In other words

> obtaining a prescription for PT such as LBP, eval

> and treat, with the MD's signature below, then

> following up with the POC for signature, and

> obtaining that signature is no longer sufficient?

>

> This is in direct contrast to my understanding at

> this time. It would be difficult to at best to

> obtain this from MD's and just seems over the top.

>

> I am hoping this presenter is wrong and would like

> to get the opinion of the forum on this matter.

>

> Sincerely,

>

> Westberg, PT

> Chicago, IL

>

> [Non-text portions of this message have been

> removed]

>

>

> ail Disclosure Statement

>

> This email and any attachments are intended solely

> for the addressee(s) named. It may contain

> confidential and privileged information that should

> remain confidential. If you are not the intended

> recipient of this message, or if it has been

> addressed to you in error, please immediately alert

> the sender by reply email and then delete this

> message and any attachments from your system. If you

> are not the intended recipient, do not deliver,

> distribute or copy this message and/or any

> attachments; and, do not disclose or take any action

> upon or rely on any information in the

> communication.

>

> ----------

>

> BEGIN:VCARD

> VERSION:2.1

> X-GWTYPE:USER

> FN:Pierce, Melinda

> TEL;WORK:492-4838

> EMAIL;WORK;PREF;NGW:mpierce@...

> N:Pierce;Melinda

> END:VCARD

>

>

>

> [Non-text portions of this message have been

> removed]

>

>