DecisionHealth, DecisionHealth - 2006 Issue 6 (June)
OIG nails physicians on PT plan of care, documentation
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Article Overview
This article reviews an HHS Office of Inspector General report on physician practices billing Medicare for physical therapy services, with emphasis on plan-of-care documentation, certification requirements, and related compliance concerns. It is relevant to physicians, practice managers, coders, and compliance staff who handle incident-to therapy services and Medicare documentation standards. The article also points readers to Medicare policy guidance and the OIG report that informed the findings.
Why This Topic Matters
It helps readers understand the compliance risks associated with incomplete physical therapy documentation and why Medicare payment for these services can be challenged when required records are missing or insufficient.
What You Will Learn
- What the OIG reviewed in physician-billed physical therapy claims
- What broad documentation elements Medicare requires for a physical therapy plan of care
- Why certification or approval of the plan is part of the compliance discussion
- How the article connects OIG findings to Medicare policy guidance
Who Should Read This
- Physicians
- Physical therapy providers
- Medical coders
- Compliance staff
- Practice managers
- Billing staff
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