US · guidance
CMS Pub. 100-04, ch. 30, § 120.3
Applicability of Limitation on Liability Provision to Claims for
Outpatient Physical Therapy Services Furnished by Clinics
(Rev. 1186, Issued: 02-23-07; Effective: 01-01-06; Implementation: 05-23-07)
A – General
The limitation on liability provision is applicable to claims for items or services furnished
by a physician-directed outpatient physical therapy (OPT) clinic that are denied on the
basis of §1862(a)(1).
The limitation on liability determination for OPT clinic claims will be made by
contractors at the initial determination level, in accordance with §120.4. The procedures
discussed in §120.2, second bullet , for determining a physician’s/supplier’s liability will
be followed when processing this category of claims.
History
(Rev. 1186, Issued: 02-23-07; Effective: 01-01-06; Implementation: 05-23-07)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
633a7d94832e428b722bd130732e3194c080b2087b6b5b9d70e3848e3fcef4bc
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