Entry By: Eileen Bach, PT, M.Ed, DPT
Pasted below is from National Association for Home Care and Hospice (NAHC) who posted the question and answer from CMS regarding single therapy in terms of 30 days/13th visit re-assessment. This only reinforces the importance of scheduling, know ing how many rehab visits are made and adherence to CMS expectations regarding re-assessments.
Hope this is helpful to those of you working in home care!
The Centers for Medicare and Medicaid (CMS) responds to an inquiry about physical therapy and visit assessments, and clarifies its policy about re-evaluation requirements.
Question: Can you please clarify this for me? If we are only doing physical therapy (PT) and the 30-day re-evaluation not only falls on the 12 visit and on a Friday and then come Monday is the 13 visit, do I have to send out the PT for another re-evaluation? We are concerned that a 30-day reassessment conducted on the 12 th PT visit in single therapy cases will not suffice to meet the 13 th therapy visit assessment. If it doesn’t meet requirements, there would be a large financial impact based on non-coverage of subsequent PT visits.
CMS Response: You are correct that for a single therapy case, the therapist must do the reassessment visit exactly on the 13 th and 19 th visits, unless the rural or documented circumstances outside the control of the therapist exceptions apply as stated in 42 CFR § 409.44(c)(2)(i)(C). If neither exception applies, the PT would need to do the reassessment on the 13 th visit as required by the regulations.