Requirements to become certified for a CORF
Your facility must be scrutinized so it meets all the Conditions of Participation for a comprehensive outpatient rehabilitation facility (CORF) in order to become certified for Medicare reimbursement.
The law states that a facility must, at a minimum:
(a) be primarily engaged in providing (by or under the supervision of physicians) diagnostic, therapeutic, and restorative services to outpatients for the rehabilitation of injured, disabled, or sick people;
(b) provide at least (I) physicians’ services who are available at the facility on a full-or part-time basis; (II) physical therapy; and (III) social or psychological services;
(c) maintain clinical records on all patients;
(d) have policies established by a group of professional personnel (associated with the facility), including one or more physicians, to govern the comprehensive outpatient rehabilitation services it furnishes, and provides for the carrying out of such policies by a full-or part-time physician referred to in paragraph (b) (I).
(e) provide that every patient be under the care of a physician;
(f) in the case of a facility in any state in which state or applicable local law provides for the licensing of facilities of this nature (I) be licensed pursuant to such law, or (II) be approved by the agency of such state or locality responsible for licensing facilities of this nature, as meeting the standard established for such licensing;
(g) have in effect a utilization review plan in accordance with regulations prescribed by the Secretary of Health and Human Services;
(h) have in effect an overall plan and budget;
(i) meet such other conditions of participation as the Secretary may find necessary in the interest of the health and safety of individuals who are furnished with services by such facilities including conditions concerning qualification of personnel in these facilities.
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