Applying for Medicare certification for physical therapy is necessary to receive benefits.
Becoming certified for physical therapy coverage under Medicare allows individuals to receive, as of 2010, around $1,800 per year for physical therapy services. Individuals must pay 20 percent while Medicare covers 80 percent of the treatment. Medicare does not automatically cover individuals seeking physical therapy. Instead, certification must be sought from the state Medicare authority. Accurately and quickly completing this process can increase the likelihood and speed of receiving Medicare support.
State Rules
Every state Medicare authority has different rules regarding what exact physical therapy and how much treatment qualifies for Medicare support. Most states, however, require a physician to set up a plan of treatment and for the treatment to be periodically re-evaluated by the prescribing physican. Individuals can find the specific rules for his or her state at www.medicare.gov. Physical therapy certification is covered under Medicare Part B.
Medicare Enrollment
Before receiving certification and coverage for physical therapy under Medicare, individuals must pay the annual deductible for taking part in Medicare Part B. The deductible, as of 2010, is approximately $155. Medicare will not certify physical therapy payments until an individual pays his or her Medicare deductible.
Location of Service
Certified Medicare physical therapy can occur in medical offices, rehabilitation facilities or in an individual's home under the supervision of qualified physicians, physician's assistants or nurses. However, outpatient physical therapy limits under Medicare Part B do not apply to hospital outpatient departments or emergency rooms. Thus, when filing for physical therapy certification, physical therapy received in these locations does not count against an individual's annual limit.
Care Plan
All proper documentation relating to a plan of care must be submitted to the appropriate authorities. A plan of care with a dated signature by a physical therapist is required to become certified. Some states like Missouri have standardized forms for filing a Letter of Intent and Request for Certification to Medicare. Physical therapy must be a specific and integral part of the treatment plan to become certified.
Proper Re-Certification
Physicians must re-certify that physical therapy is still necessary every 30 days. However, this does not mean that an individual must see a physician during this period. Instead, individuals are strongly encouraged to contact their physician to ensure that re-certification documentation has been submitted so that Medicare coverage of physical therapy continues.
Tags: physical therapy, under Medicare, Medicare Part, become certified, Certification Medicare, certification physical
