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Physician Services RoP Revisions

The physician services interpretative guidance was revised under F712 – Frequency of Physician’s Visits in the advanced copy of Appendix PP. The table included in F712 outlining who is able to complete certain visits, orders, certification and recertification was revised to include Admission Orders in each category. The table was revised as follows:

 

Initial Comprehensive Visit

Admission Orders

Other Required Visits & Orders

Other Medically Necessary Visits & Orders

Certification and Recertification

SNFs

 

 

 

 

 

PA, NP, & CNS employed by the provider

May not perform

May not provide

May perform alternate visits & sign.

May perform & sign

May not sign

PA, NP, & CNS not an employee

May not perform

May not provide

May perform alternate visits & sign

May perform & sign

May sign as permitted under State laws.

NFs

 

 

 

 

 

PA, NP, & CNS employed by the provider

May not perform

May not provide

May not perform or sign

May perform & sign.

Not applicable.

PA, NP, & CNS, not an employee

May perform

May provide*

May perform & sign

May perform & sign

Not applicable.


*A NPP may provide admission orders if a physician personally approved in writing a recommendation for admission to the provider prior to the resident’s admission.

As a reminder, physician visits must be completed at least every 30 days for the first 90 days following admission and then at least every 60 days thereafter. The interpretative guidance includes a definition of “must be seen” which states that the physician (or alternate provider as appropriate) must make actual face-to-face contact with the resident, and at the same physical location, not via telehealth arrangement. The requirement of completing face-to-face contact was waived during the COVID-19 pandemic, however, has been terminated.