Regulation .04 Covered Services.
Regulation .04 Covered Services.LinkCopy Citation
A.
The Physical Therapy Program covers medically necessary physical therapy services ordered in writing by a physician, doctor of dental surgery or of dental medicine, physician assistant, nurse practitioner, nurse midwife, or podiatrist when the services are:
(1)
Provided by a licensed physical therapist or by a licensed physical therapist assistant under a licensed physical therapist's direct supervision;
(2)
Provided in the provider’s office, the patient’s home, a domiciliary level facility, or via telehealth in accordance with COMAR 10.09.49 or other subregulatory guidance issued by the Department;
(3)
Diagnostic, rehabilitative, or therapeutic, and directly related to the written treatment order;
(4)
Of sufficient complexity and sophistication, or the condition of the patient is such, that the services of a physical therapist are required;
(5)
Rendered pursuant to a written treatment order which:
(a)
Is signed and dated by the prescriber;
(b)
Specifies the following:
(i)
Part or parts to be treated; and
(ii)
Expected results of physical therapy treatments;
(c)
Is kept on file by the therapist as a part of the patient's permanent record, subject to review by the Department or its designee; and
(d)
Is not altered by the therapist unless:
(i)
Medically indicated;
(ii)
Signed by the therapist;
(iii)
Necessary changes are made;
(iv)
The prescriber is notified of the change; and
(v)
The change is noted in the patient's record; and
(6)
Recorded in the patient's permanent record which includes:
(a)
The treatment order of the prescriber;
(b)
The initial evaluation by the therapist and significant past history;
(c)
All pertinent diagnoses and prognoses;
(d)
Contraindications, if any; and
(e)
Progress notes documented in accordance with the requirements listed in COMAR 10.38.03.02-1A(2), C, and D.
B.
The Physical Therapy Program covers an initial evaluation, on a one-time-only basis, per condition, when the requirements of §A, of this regulation, are met.
C.
If the prescribing order exceeds 30 days, the therapist shall request a new order from the prescriber for continued therapy.