Skilled nursing falls under Original Medicare Part A. Medicare Part A covers up to 100 days of skilled nursing facility care per benefit period. A benefit period begins the day you're admitted as an inpatient in a hospital or skilled nursing facility and ends when you haven't received any inpatient hospital care (or skilled care in an SNF According to this 8-Rinute Rule guide, "When calculating the number of billable units for a particular date of service, Medicare adds up the total minutes of skilled, one-on-one therapy and divides that total by 15. The revisions in Transmittal 176 incorrectly indicated that skilled physical therapy services in the skilled nursing facility (SNF) setting must "…require the skills of a qualified therapist (not an assistant) for the performance of a safe and effective maintenance program." therapy is not required to effect improvement or restoration of function where a patient suffers a transient and easily reversible loss or reduction of function (e.g., temporary weakness which may follow a brief period of bed rest following abdominal surgery) which could reasonably be expected to improve spontaneously as the patient gradually … setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes" Outpatient, Part B Benefits: Skilled maintenance therapy services must be provided by a PT, not a PTA Coverage of skilled maintenance therapy under the Medicare outpatient therapy Part B benefit does not affect the the change to allow ptas to treat came with the 2021 physician fee schedule final rule, in which cms permanently permitted physical therapists to delegate maintenance therapy services to a pta for outpatient services under medicare part b. (cms will revise the medicare benefit policy manual, chapter 15, sections 220 and 230, to clarify that pts … quality of Medicare Par B physical, occupational, and speech' therapy for skilled nursing facility patients. BACKGROUND Medicare Coverage Guidelines for Part B Physical , Occupational, and Speech Therapy Medicare guidelines state that all therapy must be reasonable, necessar, specific, and effective treatment for the patient's condition. The therapist can personally provide ongoing skilled maintenance therapy due to safety and/or complexity of your situation. In both cases, the therapist will need to document justification for ongoing PT, in order for Medicare to cover it. I have created a handout that you can provide to your PT, which details coverage, documentation, Medicare Medicare will cover maintenance care provided the level of care needed to maintain a certain level of function requires the skills (knowledge) of a physical or occupational therapist. In short, the complexity of the care must not be able to be completed by a family member, aide or anyone other than a PT/OT. 97032-97039: One-on-one modalities (constant attendance billed in 15-minute increments); 97110-97546: One-on-one procedures (therapeutic); 97597-97606: Wound care management; 97750-97755: Tests and measurements; 97760-97762: Orthotic and prosthetic management. Learn more about CPT codes for physical therapists here. The Balanced Budget Act of 1997 mandates the implementation of a per diem prospective payment system (PPS) for skilled nursing facilities (SNFs) covering all cost