Coverage of Physicians’ Services Provided in Comprehensive

80.1 - Coverage of Physicians’ Services Provided in Comprehensive Outpatient Rehabilitation Facility (Rev. 1, 10-01-03) B3-2220 Rehabilitation services furnished by comprehensive outpatient rehabilitation facilities (CORFs) are covered by Medicare Part B. Under §1832(a)(2)(E), and §1861(cc)(2) (go to http://www.ssa.gov/OP_Home/ssact/title18/1800.htm and select the applicable title) and related provisions of the Act, a CORF is recognized as a provider of services on the basis of its reasonable costs. Except for diagnostic and therapeutic services provided by physicians to individual patients, payment is made to the CORF by A/B MACs (A) (acting in the role of the A/B MAC (B).) Physicians’ diagnostic and therapeutic services furnished to a CORF patient are not considered CORF physician’s services. Instead they are services that the physician must bill to the A/B MAC (B). If covered services, payment is made according to the Medicare Physician Fee Schedule. When physician’s diagnostic and therapeutic services are furnished in a CORF, the claim must be annotated to show the CORF as the place of treatment. Services considered administrative services provided by the physician associated with the CORF are considered CORF services reimbursable to the CORF by the A/B MACs (A). Administrative services include consultation with and medical supervision of nonphysician staff, establishing and reviewing the plan of treatment, and other medical and facility administration activities.