Co-Treats on Inpatient Rehab- New Interpretation?

[Guest guest]

Dear Colleagues-

In a National Provider Call for SNF Providers by CMS yesterday 11/3/11, there

was a specific example given about co- treatment under Medicare Part A that is a

significant departure from how co-treat times are traditionally counted ( and

" billed) under Inpatient Rehab Part A (and skilled Part A).

" Co-Treatment-

Two clinicians ( two therapists, a therapist and therapy assistant or two

therapy assistants from different disciplines), each from a different

discipline, treat one Part A resident at the same time ( with different

treatments).

Example: a SLP and and OT do a meal with a patient. The OT is working on

feeding skills and fine motor coordination of the utensils and the SLP is

working on swallowing skills.

Both disciplines may code the full treatment session.

All policies regarding the mode, modalities and student supervision must be

followed.

The decision to co-treat should be made on a case by case basis and the need for

co-treatment should be well documented in the plan of care for each patient.

Only appropriate for specific clinical circumstances and not every patient,

therefore should be very limited. "

I have not seen yet anything new in the new Final Rule for Rehab along these

lines. Traditionally we would split the patient's time between the two

clinicians.

My question is this- Is anyone else using this interpretation, or considering

using, specifically on inpatient Rehab?

I look forward to your comments.

Marcy Stalvey, PT, MS, NCS

Therapy Supervisor, Inpatient Rehabilitation

Edwin Shaw Rehabilitation Institute

Cuyahoga Falls, OH 44221