Physicians’ Services

40.1 - Physicians’ Services (Rev. 111, Issued: 09-25-09; Effective Date: 07-07-08; Implementation Date: 10-26- 09) Certain administrative services provided by a qualified physician, as defined at 42CFR485.70(a), associated with the CORF are considered CORF physician services, which are not billable by the CORF. These services include administrative services provided by the physician associated with the CORF, such as: • consultation with and medical supervision of nonphysician staff, • team conferences, • case reviews, and • other facility medical and administration activities necessary to the provision of skilled rehabilitation services, and • Other services that directly relate to the rehabilitation plan of treatment. Examinations for the purpose of establishing and reviewing the rehabilitation plan of care that do not result in a billable service would also represent CORF physician services. Physicians’ diagnostic and therapeutic services (e.g., evaluation and management services, debridement, electrocardiography (ECG)), furnished to an individual CORF patient are not CORF physicians’ services. They are physician services and are billable to the Medicare contractor, as appropriate. The physician, not the CORF, bills for and is paid by Medicare for these services. The physician claim must be clearly annotated to show the CORF as the place of treatment, which is paid at the nonfacility physician fee schedule rate.