Hosp-based Off-Site Outpatient Rehab Supervision

[Guest guest]

Hello Group,

I've recently joined a health system which includes one hospital-based, off-site

outpatient physical and occupational therapy clinic. I've been informed by our

Risk manager that Medicare requires on-site physician supervision, meaning that

a physician must be in the building whenever a Medicare client is seen for

therapy. According to her, this was a Medicare ruling in 2001. (In fact, she

is following a discussion that indicates the ruling was misinterpreted all this

time and really means that the physician must be in the room!) This apparently

doesn't apply to non-hospital-based outpatient centers, and any on-site centers

are assumed to have a physician in the Emergency Department. I have worked in

both the private practice and hospital arenas, including hospital-based,

off-site outpatient therapy centers and I've never heard of this ruling before.

In fact, many centers I'm aware of don't have a physician for miles. My

questions to the group:

- Have you ever heard of this ruling or discussion before?

- Does your hospital have off-site outpatient therapy and if so, how do you meet

this requirement while still providing access for extended hours (evenings,

weekends, etc)?

- Is APTA/AOTA involved in this discussion? I haven't heard anything.

Any feedback is appreciated! I do have copies (pdf files) of letters discussing

the ruling, etc if you're interested.

Christen, PT

Kchristen1@...

Director of Rehabilitation Services

FHN

Freeport, IL