CFR > Title 42 - Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM (parts 405 to 426) > PART 424—CONDITIONS FOR MEDICARE PAYMENT > SUBPART B—Certification and Plan Requirements (§424.10 to §424.27) > 424.27—Requirements for comprehensive outpatient rehabilitation facility (CORF) services.

424.27—Requirements for comprehensive outpatient rehabilitation facility (CORF) services.

Medicare Part B pays for CORF services only if a physician certifies, and the facility physician recertifies, the content specified in paragraphs (a) and (b)(2) of this section, as appropriate.
(a) Certification: Content. (1) The services were required because the individual needed skilled rehabilitation services;
(2) The services were furnished while the individual was under the care of a physician; and
(3) A written plan of treatment has been established and is reviewed periodically by a physician.
(b) Recertification— (1) Timing. Recertification is required at least every 60 days for respiratory therapy services and every 90 days for physical therapy, occupational therapy, and speech-language pathology services based on review by a facility physician or the referring physician who, when appropriate, consults with the professional personnel who furnish the services.
(2) Content. (i) The plan is being followed;
(ii) The patient is making progress in attaining the rehabilitation goals; and,
(iii) The treatment is not having any harmful effect on the patient.
[53 FR 6634, Mar. 2, 1988, as amended at 72 FR 66405, Nov. 27, 2007]