This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Moorhead, J. F. Articles by Clifford, J. Search for Related Content PubMed PubMed Citation Articles by Moorhead, J. F. Articles by Clifford, J. Social Bookmarking                         What's this?

Determining Medical Necessity of Outpatient Physical Therapy Services

Spaulding Rehabilitation Hospital, Boston, Massachusetts

Joanne Clifford, M.S., P.T.

Spaulding Rehabilitation Hospital, Boston, Massachusetts

A patient referred for physical therapy may attend one or several therapy visits or may continue to re ceive ongoing therapy services several times weekly for several months. The question of the continued medical necessity of those services arises often.

Determination of medical necessity for continued therapy services requires knowledge of the natural history of diseases that may require therapy services, familiarity with the effectiveness of treatment alter natives for those diseases, and awareness of commu nity practice patterns. Accurate and complete docu mentation from the therapist or referring physician is required for the physician advisor or utilization review consultant to make an accurate determination of medical necessity. A structured format for provid ing this documentation is suggested.

American Journal of Medical Quality, Vol. 7, No. 3, 81-84 (1992)
DOI: 10.1177/0885713X9200700304


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?