[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR410.61]



[Page 346-347]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 410_SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS--Table of Contents

 

               Subpart B_Medical and Other Health Services

 

Sec. 410.61  Plan of treatment requirements for outpatient rehabilitation 

services.



    (a) Basic requirement. Outpatient rehabilitation services (including 

services furnished by a qualified physical or occupational therapist in 

private practice), must be furnished under a written plan of treatment 

that meets the requirements of paragraphs (b) through (e) of this 

section.

    (b) Establishment of the plan. The plan is established before 

treatment is begun by one of the following:

    (1) A physician.

    (2) A physical therapist who furnishes the physical therapy 

services.

    (3) A speech-language pathologist who furnishes the speech-language 

pathology services.

    (4) An occupational therapist who furnishes the occupational therapy 

services.

    (5) A nurse practitioner, a clinical nurse specialist, or a 

physician assistant.

    (c) Content of the plan. The plan prescribes the type, amount, 

frequency, and duration of the physical therapy,



[[Page 347]]



occupational therapy, or speech-language pathology services to be 

furnished to the individual, and indicates the diagnosis and anticipated 

goals.

    (d) Changes in the plan. Any changes in the plan--

    (1) Are made in writing and signed by one of the following:

    (i) The physician.

    (ii) The physical therapist who furnishes the physical therapy 

services.

    (iii) The occupational therapist that furnishes the occupational 

therapy services.

    (iv) The speech-language pathologist who furnishes the speech-

language pathology services.

    (v) A registered professional nurse or a staff physician, in 

accordance with oral orders from the physician, physical therapist, 

occupational therapist, or speech-language pathologist who furnishes the 

services.

    (vi) A nurse practitioner, a clinical nurse specialist, or a 

physician assistant.

    (2) The changes are incorporated in the plan immediately.

    (e) Review of the plan. (1) The physician reviews the plan as often 

as the individual's condition requires, but at least every 30 days.

    (2) Each review is dated and signed by the physician who performs 

it.



[53 FR 6638, Mar. 2, 1988; 53 FR 12945, Apr. 20, 1988, as amended at 54 

FR 38680, Sept. 20, 1989; 54 FR 46614, Nov. 6, 1989. Redesignated at 56 

FR 8854, Mar. 1, 1991; 56 FR 23022, May 20, 1991; 63 FR 58907, Nov. 2, 

1998; 67 FR 80040, Dec. 31, 2002]