CMS SOM App. FC, Tag M0368

described in §424.24(d) of this chapter.

Interpretive Guidelines §485.918(g)(4)

The intensive outpatient services requirements specified in §424.24(d) are:

Content of certification and plan of treatment requirements—

(1) Content of certification.

(i) The individual requires such services for a minimum of 9 hours per week.

(ii) The services are or were furnished while the individual was under the care of a

physician.

(iii) The services were furnished under a written plan of treatment that meets the

requirements of paragraph (d)(2) of this section.

(2) Plan of treatment requirements.

(i) The plan is an individualized plan that is established and is periodically

reviewed by a physician in consultation with appropriate staff participating in the

program, and that sets forth—

(A) The physician’ s diagnosis;

(B) The type, amount, duration, and frequency of the services; and

(C) The treatment goals under the plan.

(ii) The physician determines the frequency and duration of the services taking into

account accepted norms of medical practice and a reasonable expectation of

improvement in the patient’ s condition.

(3) Recertification requirements—

(i) Signature. The physician recertification must be signed by a physician who is

treating the patient and has knowledge of the patient’ s response to treatment.

(ii) Timing. Recertifications are required at intervals established by the provider,

but no less frequently than every 60 days.

(iii) Content. The recertification must specify that the patient continues to require at

least 9 hours of intensive outpatient services and describe the following:

(A) The patient’ s response to the therapeutic interventions provided by the

intensive outpatient program.

(B) The patient’ s psychiatric symptoms that continue to place the patient at

risk of relapse or hospitalization.

(C) Treatment goals for coordination of services to facilitate discharge from

the intensive outpatient program.