US · guidance
CMS Pub. 100-02, ch. 15, § 220.1.1
Care of a Physician/Nonphysician Practitioner (NPP)
Although there is no Medicare requirement for an order, when documented in the medical
record, an order provides evidence that the patient both needs therapy services and is
under the care of a physician. The certification requirements are met when the physician
certifies the plan of care. If the signed order includes a plan of care (see essential
requirements of plan in §220.1.2), no further certification of the plan is required.
Payment is dependent on the certification of the plan of care rather than the order, but the
use of an order is prudent to determine that a physician is involved in care and available
to certify the plan.
(The CORF services benefit does not recognize an NPP for orders and certification.)
History
(Rev. 179, Issued: 01-14-14, Effective: 01-07-14, Implementation: 01-07-14)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
f5d2432213d54c5e0074163699188b328d7d303f3555d8a8d5841bfddb9421d0
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