Application of the General Principles to Occupational Therapy

40.2.4 - Application of the General Principles to Occupational Therapy (Rev. 179, Issued: 01-14-14, Effective: 01-07-14, Implementation: 01-07-14) A3-3118.2.D, HHA-205.2.D The following discussion of skilled occupational therapy services applies the principles to specific occupational therapy services about which questions are most frequently raised. Coverage of occupational therapy services is not determined solely on the presence or absence of a beneficiary’s potential for improvement from the therapy, but rather on the beneficiary’s need for skilled care. Assuming all other eligibility and coverage requirements have been met, skilled occupational therapy services are covered when the individualized assessment of the patient’s clinical condition demonstrates that the specialized judgment, knowledge, and skills of a qualified occupational therapist are necessary.