Physical Therapy Certification for Medicare Patients

Proper, effective, legal documentation ensures certication of Medicare patients.

Therapists must provide detailed, patient-specific documentation upon evaluation to certify therapy services for their Medicare patients. This paperwork must follow detailed guidelines and demonstrate significant medical and physical deficits.

Selection of Medical Diagnoses

When documenting your evaluation of a Medicare patient you must select accurate diagnosis codes, which are supported by the doctor's documented diagnosis. Honing in on the most specific code possible provides your certification with increased support for reimbursement.

Evidence of Decline from Functional Baseline

Delineating the actual functional baseline of your patient prior to his most recent medical changes is essential to proving the patient's need for therapy. Demonstrating the change in the patient's independence will support your therapeutic interventions, and the expense involved.

Functional Goals

Many therapists overlook the importance of associating every goal with a significant functional outcome. Every goal should have objective, measurable portions that can legally demonstrate the progress your patient achieves. Medicare reviewers are usually nurses, so your goals should be geared toward their level of understanding of therapy.

References

• Centers for Medicare and Medicaid: Medicare Claims Processing Manual