Is a physicians written plan of care or referral necessary for a speech-language pathologist to perform certain procedures under Medicare?
A physician referral is not required for Medicare patients. The Medicare program allows the plan of care to be established by the physician or the speech-language pathologist. If the plan of care is written by the speech-language pathologist, it must be certified by the patient’s physician within 30 days. For outpatient services, the plan of care must be recertified by the physician every 90 days from the initiation of treatment or when there is a significant modification to the plan. The physician must review the plan of care every 60 days for home health agencies and Comprehensive Outpatient Rehabilitation Facilities. The physician or speech-language pathologist can make changes in the plan of care. The speech-language pathologist may not significantly alter a plan of care without recertification from the physician. Medicare requirements for a plan of care are set forth in the Medicare Benefit Policy Manual, Chapter 15, Section 220.1.2 [PDF, 1.2MB].
