How to Complete a Plan of Care for Medicare Part B Patients

Please note that this article contains information that is only relevant to American clinics.


When your clinic begins seeing Medicare Part B patients, you’ll need to complete a ‘plan of care’ for them. This provides an overview of the treatment that you’ll be providing. But, it’s not as simple as writing a bullet list of CPT codes—it’s a bit more complicated than that. In this article, we’ll be discussing how to complete a plan of care for Medicare Part B patients.


Required Elements of a Plan of Care


Outpatient PT, OT, and SLP services provided under Medicare Part B need several pieces of information to be included in their plan of care. Among the most common inclusions are: diagnoses, the type of treatment, the amount of treatment required, and the long term treatment goals. With the help of Gawenda Seminars and Consulting, we’ll explain each of these requirements.


Click here to read the top 5 things you need to know about amended medical records.


Now, the type of treatment always refers to the discipline of the therapist drafting the plan of care (i.e. PT, OT, SLP). The amount of treatment indicates the number of times a day that the patient requires treatment. Frequency refers to the number of times in a week that treatment is provided. And duration states the total number of weeks for this specific plan of care.


But there’s one more important piece of information that must be included in a plan of care for Medicare Part B patients.


Signing Your Medicare Part B Patients’ Plan of Care


With Medicare Part B plans of care, it’s extremely important to ensure that they’re signed and certified by the correct type of healthcare professional.  As such, there are two types that we will be speaking about.


The first are physicians. In the scope of outpatient therapy plans of care, Medicare considers a physician to be a licensed MD, DO, podiatrist, or optometrist (in cases where low vision services are required).


The second type of healthcare professional that can sign off a Medicare plan of care are non physician practitioners (NPP). According to Medicare, these are considered to be clinical nurse specialists, nurse practitioners, and physician assistants.


Furthermore, an article from Gawenda Seminars and Consulting stated that “You must also refer to your respective state practice act and administrative rules…to determine who you can accept orders and referrals from.”


We hope you found this article helpful. For more information like this, please visit the Gawenda Seminars and Consulting website and learn more about the benefits of becoming a Gold Member.

top icon