Medicare Part B pays for CORF services only if a physician certifies, and the facility physician recertifies, the content specified in paragraphs (a) and (b)(2) of this section, as appropriate.
(a) Certification: Content.
(1)
The services were required because the individual needed skilled rehabilitation services;
(2)
The services were furnished while the individual was under the care of a physician; and
(3)
A written plan of treatment has been established and is reviewed periodically by a physician.
(b) Recertification—
(1) Timing.
Recertification is required at least every 60 days for respiratory therapy services and every 90 days for physical therapy, occupational therapy, and speech-language pathology services based on review by a facility physician or the referring physician who, when appropriate, consults with the professional personnel who furnish the services.
(2) Content.
(i)
The plan is being followed;
(ii)
The patient is making progress in attaining the rehabilitation goals; and,
(iii)
The treatment is not having any harmful effect on the patient.
[53 FR 6634, Mar. 2, 1988, as amended at 72 FR 66405, Nov. 27, 2007]