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Per Medicare Policy - The physician may refer the patient to a licensed/certified medical professional, such as a physical therapist (PT)or occupational therapist (OT), who has experience and training in mobility evaluations to perform part of the face-to-face examination. This person may have no financial relationship with the supplier. (Exception: If the supplier is owned by a hospital, PT or OT working in the inpatient or outpatient hospital setting may perform part of the face-to-face examination.)
Pride Mobility Products has compiled a database of physical and occupational therapists (independent, home health agencies, wheelchair clinics) who have experience and training in mobility evaluations. The Therapist Locator Database was created to assist Pride and Quantum providers locate a therapist near the patient who may be able to perform part of the face-to-face examination (upon physician referral). Providers may not have a financial relationship with the therapist who performs part of the face-to-face examination.
If the patient was referred before being seen by the physician, then once the physician has received and reviewed the written report of this examination, the physician must see the patient and perform any additional examination that is needed. The report of the physician's visit shall state concurrence or any disagreement with the LCMP examination. In this situation, the physician must provide the supplier with a copy of both examinations within 45 days after the face-to-face examination with the physician.
If the physician saw the patient to begin the examination before referring the patient to an LCMP, then if the physician sees the patient again in person after receiving the report of the LCMP examination, the 45-day period begins on the date of that second physician visit. However, it is also acceptable for the physician to review the written report of the LCMP examination, to sign and date that report, and to state concurrence or any disagreement with that examination. In this situation, the physician must send a copy of the note from his/her initial visit to evaluate the patient plus the annotated, signed, and dated copy of the LCMP examination to the supplier. The 45-day period begins when the physician signs and dates the LCMP examination.
If you would like a list of PTs/OTs who have experience and training in mobility evaluations please have the patient's ZIP code available and contact Pride’s Education Team at 800-800-8586 ext:1071. A member of the team will be glad to search our database and provide you with the name(s) and phone number(s) of independent therapists, wheelchair clinics and home health agencies within a 50 miles radius of your patient's Zip Code. You may then provide this list to your patient and/or their physician so they may select a therapist for the evaluation. You should NOT choose/refer a therapist for a patient.
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