Forum - Questions & Answers
PT/OT in Nursing Facility
If a physician rents space in a nursing home and opens a PT/OT office within the nursing home, is their any specific guideline about how often the physician has to evaluate the patient?
What is is guideline for the attending physician as far a evaluations?
PT/OT in Nursing facility
I believe these are not billable to Part B, because all therapy services in a SNF and NF are part of consolidated billing. That is, the nursing home payment from Medicare/Medicaid includes payment for therapy.
Research this very carefully, or so that you don't find you went to a lot of expense and cannot get reimbursed.
There's an article in Codapedia on the topic, with some resources and citations. Search for "consolidated billing" in the box above "Look it up!"
And as to oversight...
I do not think there is a rule about "how often" the doc must see the patient. Therapy must be ordered by a physician (and a written order should be kept on file) and medically indicated for the condition and should continue only if progress is made towards goals. Therapy to maintain an level of functioning is not not covered.