# Medicare pays for therapy only if a clinician personally performs the evaluation, not by summarising measurements others took

Page: https://flyvolo.ai/en/changes/ev-20190101-physical-therapist-3
Date: 2019-01-01 · Stage: Constraint
Can this record move a task judgement? yes
Occupation: https://flyvolo.ai/en/careers/physical-therapist

## Scope

United States, Medicare. The manual says only a clinician may perform an initial examination, evaluation, re-evaluation and assessment or establish a diagnosis or plan of care; that the clinician must actively and personally participate in the evaluation and may not merely summarise the objective findings of others or make judgements drawn from others' measurements; and that a clinician is a physician, non-physician practitioner or therapist, not an assistant or aide. A payment rule rather than a practice act; it does not mention software or motion capture.

## Source

- Centers for Medicare & Medicaid Services — Medicare Benefit Policy Manual, Chapter 15, §220.3.C (Rev. 255, effective 1 January 2019) — https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c15.pdf (primary source)

## What this means

For Medicare patients in the US, the assessment has to be done by the therapist in person to be paid for.

## What it does not show yet

A payment rule for one programme; it does not ban other tools from collecting measurements.

## How to verify it yourself

Open Chapter 15 of the Medicare Benefit Policy Manual, go to §220.3.C, and find "may not merely summarize the objective findings of others".


More: https://flyvolo.ai/llms.txt