According to Medicare Local Coverage Determination (LCD) Therapy and Rehabilitation Services (PT, OT) (L35036) covered Indications GENERAL PHYSICAL MEDICINE & REHABILITATION (PM&R) GUIDELINES PM&R services in patients’ homes, qualified professionals’ offices, Skilled Nursing Facilities (SNFs), outpatient hospital clinics, Outpatient Rehabilitation Facilities (ORFs) and Comprehensive Outpatient Rehabilitation Facilities (CORFs) are covered when reasonable and medically necessary for the treatment of the patient’s condition (signs and symptoms).
Mobile unit POS 15 not mentioned.
Special Considerations for Mobile Unit Settings (Code 15)
When services are furnished in a mobile unit, they are often provided to serve an entity for which another POS code exists. For example, a mobile unit may be sent to a physician’s office or a SNF. If the mobile unit is serving avn entity for which another POS code already exists, providers should use the POS code for that entity. However, if the mobile unit is not serving an entity which could be described by an existing POS code, the providers are to use the Mobile Unit POS code 15. Medicare will apply the non-facility rate to payments for services designated as being furnished in POS code 15 and apply the appropriate facility or non-facility rate for the POS code designated when a code other than the mobile unit code is indicated. A physician or practitioner's office, even if mobile, qualifies to serve as a telehealth originating site. Assuming such an office also fulfills the requirement that it be located in either a rural health Professional Shortage Area as defined under Section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A)) or in a county that is not included in a Metropolitan Statistical Area as defined in Section 1886(d)(2)(D) of the Social Security Act, the originating physician's office should use POS code 11 (Office) in order to ensure appropriate payment for services on the list of Medicare Telehealth Services.
Thanks to SlavaK and ElinaS.
