Medicare Benefit Policy Manual (Pub. 100-02), Ch. 7 § 40.2.4.2
Planning, Implementing, and Supervision of Therapeutic
40.2.4.2 - Planning, Implementing, and Supervision of Therapeutic
Programs
(Rev. 1, 10-01-03)
A3-3118.2.D.2, HHA-205.2.D.2
The planning, implementing, and supervision of therapeutic programs including, but not
limited to those listed below are skilled occupational therapy services, and if reasonable
and necessary to the treatment of the patient's illness or injury would be covered.
A. Selecting and Teaching Task Oriented Therapeutic Activities Designed to
Restore Physical Function.
EXAMPLE: Use of woodworking activities on an inclined table to restore shoulder,
elbow, and wrist range of motion lost as a result of burns.
B. Planning, Implementing, and Supervising Therapeutic Tasks and Activities
Designed to Restore Sensory-Integrative Function.
EXAMPLE: Providing motor and tactile activities to increase sensory output and
improve response for a stroke patient with functional loss resulting in a distorted body
image.
C. Planning, Implementing, and Supervising of Individualized Therapeutic Activity
Programs as Part of an Overall "Active Treatment" Program for a Patient With a
Diagnosed Psychiatric Illness.
EXAMPLE: Use of sewing activities that require following a pattern to reduce
confusion and restore reality orientation in a schizophrenic patient.
D. Teaching Compensatory Techniques to Improve the Level of Independence in
the Activities of Daily Living.
EXAMPLE: Teaching a patient who has lost use of an arm how to pare potatoes and
chop vegetables with one hand.
EXAMPLE: Teaching a stroke patient new techniques to enable them to perform
feeding, dressing, and other activities of daily living as independently as possible.
E. The Designing, Fabricating, and Fitting of Orthotic and Self-Help Devices.
EXAMPLE: Construction of a device which would enable a patient to hold a utensil and
feed themselves independently.
EXAMPLE: Construction of a hand splint for a patient with rheumatoid arthritis to
maintain the hand in a functional position.
F. Vocational and Prevocational Assessment and Training
Vocational and prevocational assessment and training that is directed toward the
restoration of function in the activities of daily living lost due to illness or injury would
be covered. Where vocational or prevocational assessment and training is related solely
to specific employment opportunities, work skills, or work settings, such services would
not be covered because they would not be directed toward the treatment of an illness or
injury.