The Centers for Medicare & Medicaid Services (CMS) has rescinded interpretive guidance it issued last fall pertaining to the ordering of rehabilitation and respiratory care services under the hospital Conditions of Participation (CoPs) and issued new guidance enabling hospital outpatient departments to accept orders from outside practitioners.
 
Many hospitals allow licensed clinicians to order outpatient rehabilitation and respiratory care services as long as state law permits it within the scope of their practice. The ordering clinician does not have to be on the hospital medical staff. The rescinded interpretive guidance required practitioners to have medical staff privileges to order rehabilitation and respiratory care services at hospitals, a requirement that would have created barriers for patients who live in areas with limited services, who need specialized therapy services, and who travel to undergo medical procedures.
 
CMS did not intend to create barriers to care in issuing these privileging requirements and quickly agreed to review the policy after hearing concerns from hospital and physical therapy groups. The new interpretive guidance allows non-privileged practitioners to order rehabilitation and respiratory care services at hospital outpatient departments in accordance with state license/scope of practice and written hospital policy. Specifically, the new policy allows outpatient services in hospitals to be ordered by a practitioner who is:
Licensed in, or holds a license recognized in the jurisdiction where he/she sees thepatient;
Acting within his/her scope of practice under state law; and
Authorized by the medical staff to order the applicable outpatient services under a written hospital policy that is approved by the governing body.