Md. Code Regs. 10.09.17.04

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.17.04 - Covered Services

A. The Physical Therapy Program covers medically necessary physical therapy services ordered in writing by a physician, doctor of dental surgery or of dental medicine, physician assistant, nurse practitioner, nurse midwife, or podiatrist when the services are:

(1) Provided by a licensed physical therapist or by a licensed physical therapist assistant under a licensed physical therapist's direct supervision;

(2) Provided in the provider's office, the patient's home, a domiciliary level facility, or via telehealth in accordance with COMAR 10.09.49 or other subregulatory guidance issued by the Department;

(3) Diagnostic, rehabilitative, or therapeutic, and directly related to the written treatment order;

(4) Of sufficient complexity and sophistication, or the condition of the patient is such, that the services of a physical therapist are required;

(5) Rendered pursuant to a written treatment order which:

(a) Is signed and dated by the prescriber,

(b) Specifies the following:

(i) Part or parts to be treated; and

(ii) Expected results of physical therapy treatments;

(c) Is kept on file by the therapist as a part of the patient's permanent record, subject to review by the Department or its designee; and

(d) Is not altered by the therapist unless:

(i) Medically indicated;

(ii) Signed by the therapist;

(iii) Necessary changes are made;

(iv) The prescriber is notified of the change; and

(v) The change is noted in the patient's record; and

(6) Recorded in the patient's permanent record which includes:

(a) The treatment order of the prescriber;

(b) The initial evaluation by the therapist and significant past history;

(c) All pertinent diagnoses and prognoses;

(d) Contraindications, if any; and

(e) Progress notes documented in accordance with the requirements listed in COMAR 10.38.03.02-1A(2), C, and D.

B. The Physical Therapy Program covers an initial evaluation, on a one-time-only basis, per condition, when the requirements of §A, of this regulation, are met.

C. If the prescribing order exceeds 30 days, the therapist shall request a new order from the prescriber for continued therapy.

Md. Code Regs. 10.09.17.04

Regulations .04 amended as an emergency provision effective December 2, 1992 (19:26 Md. R. 2282); amended permanently effective June 1, 1993 (20:10 Md. R. 851)
Regulations .04 amended as an emergency provision effective February 8, 1995 (22:5 Md. R. 364); emergency status expired May 31, 1995; amended permanently effective June 5, 1995 (22:11 Md. R. 821); amended effective 45:17 Md. R. 803, eff. 8/27/2018; amended effective 50:15 Md. R. 681, eff. 8/7/2023