Become A Medicare Therapy Provider

Most outpatient rehab providers participate in the Medicare program.  Medicare outpatient services are paid for out of the Part B Medicare Trust Fund.  Outpatient Rehab participation can be in several ways:

• Part B Provider/Suppplier - Medicare Contractor is the Carrier
  • Physical or Occupational Therapist in Private Practice (PTPP/OTPP)
  • Physical or Occupational Therapy Group Practice
  • Services provided ‘incident’ to a physician’s practice
• Part A (Institutional) Provider -Medicare Contractor is the Fiscal Intermediary
  • Rehab Agency
  • CORF
  • Hospital Outpatient Department

Medicare rehab providers are certified based upon the Conditions of Participation for each type of provider found in the Code of Federal Regulations.  Part A providers (Rehab Agencies & CORFs) make application to the Fiscal Intermediary, and they are subject to the survey and certification requirments (conducted by the State Agency) for each program.  State surveyors use interpretive guidelines to guide them in the survey and certification process.

Part B providers (private practice) make application through the Carrier, and may at the discretion of the carrier, be subject to survey conducted by the Carrier.

 

quick links

10-6-2008: CMS Announces New Recovery Audit Contractors (RACs)

10-4-2008: OIG Releases New Rehab Fraud Case.

10-1-2008:  OIG Issues 2009 Work Plan:  Private practice therapy is identified.