tci Medicare Compliance & Reimbursement - 2012 Issue 10

Rural Health: Follow the Updated Definition of "Privileged" Provider for Ordering Hospital Services

CMS clarifies Transmittal 72 regarding rehab, respiratory care referrals. If you work in a rural health setting, take note: CMS released updated guidelines in 2011 regarding physician orders for hospital rehabilitation and respiratory care services. Now CMS has further clarified Transmittal 72 (https://www.cms.gov/transmittals/downloads/R72SOM.pdf), so make sure your physicians know about the latest change in order to follow it. Background: Transmittal 72 included broad language stating that hospital rehabilitation and respiratory care services must be ordered by a qualified and licensed practitioner who is responsible for the patient's care and who is authorized by the hospital medical...

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