physical therapy services and other therapy services under medicare

physical therapy services and other therapy services under medicareSec. 251. (a) (1) Section 1861(p) of the Social Security Act is amended by adding at the end thereof (after and below paragraph (4) (B)) the following new sentence: “The term ‘outpatient physical therapy services’ also includes physical therapy services furnished an individual by a physical therapist (in his office or in such individual’s home) who meets licensing and other standards prescribed by the Secretary in regulations, otherwise than under an arrangement with and under the supervision of a provider of services, clinic, rehabilitation agency, or public health agency, if the furnishing of such services meets such conditions relating to health and safety as the Secretary may find necessary.” (2) Section 1833 of such Act is amended by adding at the end thereof the following new subsection: “(g) In the case of services described in the next to last sentence of section 1861 (p), with respect to expenses incurred in any calendar year, no more than $100 shall be considered as incurred expenses for purposes of subsections (a) and (b).” (3) Section 1833(a) (2) of such Act (as amended by section 233(b) of this Act) is further amended by striking out the period at the end of subparagraph (B) and inserting in lieu thereof “; or”, and by adding after subparagraph (B) the following new subparagraph: “(C) if such services are services to which the next to last sentence of section 1861 (p) applies, the reasonable charges for such services.” (4) Section 1832(a)(2)(C) of such Act is amended by striking out “services.” and inserting in lieu thereof “services, other than services to which the next to last sentence of section 1861 (p) applies.” (b) (1) Section 1861 (p) of such Act (as amended by subsection (a)(1) of this section) is further amended by adding at the end thereof the following new sentence: “In addition, such term includes physical therapy services which meet the requirements of the first sentence of this subsection except that they are furnished to an individual as an inpatient of a hospital or extended care facility.” (2) Section 1835(a)(2)(C) of such Act is amended by striking out “on an outpatient basis”. (c) Section 1861 (v) of such Act (as amended by sections 221(c) (4) and 223(f) of this Act) is further amended by redesignating paragraphs (5) and (6) as paragraphs (6) and (7), respectively, and by inserting after paragraph (4) the following new paragraph: “(5) (A) Where physical therapy services, occupational therapy services, speech therapy services, or other therapy services or services of other health-related personnel (other than physicians) are furnished under an arrangement with a provider of services or other organization, specified in the first sentence of section 1861 (p) the 86 Stat. 1446amount included in any payment to such provider or other organization under this title as the reasonable cost of such services (as furnished under such arrangements) shall not exceed an amount equal to the salary which would reasonably have been paid for such services (together with any additional costs that would have been incurred by the provider or other organization) to the person performing them if they had been performed in an employment relationship with such provider or other organization (rather than under such arrangement) plus the cost of such other expenses (including a reasonable allowance for travel time and other reasonable types of expense related to any differences in acceptable methods of organization for the provision of such therapy) incurred by such person, as the Secretary may in regulations determine to be appropriate. “(B) Notwithstanding the provisions of subparagraph (A), if a provider of services or other organization specified in the first sentence of section 1861 (p) requires the services of a therapist on a limited part-time basis, or only to perform intermittent services, the Secretary may make payment on the basis of a reasonable rate per unit of service, even though such rate is greater per unit of time than salary related amounts, where he finds that such greater payment is, in the aggregate, less than the amount that would have been paid if such organization had employed a therapist on a full- or part-time salary basis.” (d) (1) The amendments made by subsection (a) shall apply with respect to services furnished on or after July 1, 1973. (2) The amendments made by subsection (b) shall apply with respect to services furnished on or after the date of enactment of this Act. (3) The amendments made by subsection (c) shall be effective with respect to accounting periods beginning after December 31, 1972.