Optional CORF Services

20.2 - Optional CORF Services (Rev. 111, Issued: 09-25-09; Effective Date: 07-07-08; Implementation Date: 10-26- 09) In addition to the three required core CORF services, the CORF may furnish any of the other covered and medically necessary items and services listed in §20.2. These optional services must directly relate to, and be consistent with, the rehabilitation plan of treatment, and must be necessary to achieve the patient’s rehabilitation goals. When a CORF provides occupational therapy, speech-language pathology and/or respiratory therapy services in addition to the required physical therapy services, the physical therapy services shall represent the predominate rehabilitation service provided. For discussion of payment rules see section 30.1. The CORF may provide any or all of the following rehabilitation services: • Occupational therapy - services include assessment of an individual’s level of independent functioning, selection and teaching of task-oriented therapeutic activities to restore sensory-integrative functions, teaching of compensatory techniques to permit an individual with a physical or cognitive impairment or limitation to engage in daily activities (See 42CFR410.100(c) and section 40.3); • Speech - Language pathology - services for the diagnosis and treatment of speech and language disorders that create difficulties in communication or dysphagia (swallowing difficulties). (See 42CFR410.100(d) and section 40.4); • Respiratory therapy - services includes only those services that can be appropriately provided to CORF patients by a qualified respiratory therapist (42CFR485.70(j)) under a physician-established respiratory therapy plan of treatment in accordance with current medical and clinical standards (See 42CFR410.100(e) and section 40.5); • Prosthetic and orthotic devices - includes testing, fitting, or training in the use of such devices (See 42CFR410.100(f) and (g) and section 40.6); • Nursing – includes nursing services (e.g., teaching self catheterization) that directly relate to and are specified in the rehabilitation plan of treatment, are necessary for the attainment of the rehabilitation goals and are provided by a registered nurse as defined in 42CFR485.70(h). (See 42CFR410.100(i) and section 40.8); • Drugs -and biologicals – which are not excluded from Part B payment, including those that are self-administered, specified at 42CFR410.29, however, there are no drugs identified which can be provided in a CORF (Calendar Year (CY) 2008 Physician Fee Schedule (PFS) Rule 72 FR 66293). (See 42CFR410.100(j) and section 40.9); • Supplies and Durable Medical Equipment (DME) – CORFs may not bill separately for the supplies they furnish except for those cast and splint supplies that are used in conjunction with the corresponding Current Procedural Terminology code. (See 42CFR410.100(k) and section 40.6); and • A single physical therapy, occupational therapy, or speech-language pathology home environment evaluation visit as appropriate – this includes evaluating the potential impact of the home environment on the rehabilitation goals (See 42CFR410.100(l) and section 40.10).