To ensure that therapy services relate directly and specifically to a treatment regimen designed to treat the beneficiary’s illness or injury, CMS is proposing to clarify their coverage requirements by revising 42 CFR 409.44(c)(1). Specifically, these clarifications are related to the (a) patient’s (therapy) plan of care, (b) therapy treatment goals, and (c) clinical record inclusion of objective measurement of function in accordance with accepted standards of clinical practice. CMS does not, however, identify any specific tests or measures expected to be utilized, leaving that decision up to the therapist or agency (as established in policy and procedure). Learn what factors to consider when determining if a specific test or measure is an appropriate instrument.
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