WSTRA National Public Policy
Recap of the ATRA RT Medicare Project
Over the past several years, the American Therapeutic Recreation Association (ATRA) has been engaged in an initiative to have the Centers for Medicare and Medicaid Services (CMS) acknowledge that recreational therapy (RT) services, when prescribed by a physician, is a covered service in Inpatient Rehabilitation Facilities (IRFs), Inpatient Psychiatric Facilities (IPFs) and Skilled Nursing Facilities (SNFs). On July 31, 2009, CMS issued final rules covering the Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2010.
From the ATRA website
Outcome
Following an extensive campaign to seek written clarification that RT is a covered service and to seek the inclusion of RT services as an option under the 3-hour guideline for IRFs, CMS issued final rules. In summary, CMS did identify RT as a covered service, when ordered by a physician as part of the overall rehabilitation plan. This is the first time they have acknowledged this in writing, thus, meaning we met our first goal of the RT Medicare Project. This is one hurdle that we can all be excited about for the profession. CMS did not, however, include RT as a service under the 3- hour guideline as a service that could be used in place of the required physical therapy, occupational therapy, speech-language pathology or prosthetics/orthotics services. While the initiative to seek inclusion of RT in the 3-hour guideline was not successful, the written acknowledgement that RT is a covered service under Medicare for IRFs was accomplished. The final rule goes into effect for Federal Fiscal Year 2010 (October 1, 2009 - September 2010).
From the ATRA website
Next Steps
ATRA will be exploring the interpretations by CMS and seeking clarification of feedback provided in the final rule.
From the ATRA website
