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Group Therapy Requirements for Medicare Part A and Part B

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L

December 7, 2016

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Question

Can you review the requirements for Medicare Part A and B circumstances for group therapy? 

Answer

For Medicare Part A, four patients is a group. They should be doing like or similar activities, but I guess they don't have to be. Medicare Part B is two or more people who may or may not be doing the same thing. Medicare Part B does not have a definition for concurrent therapy.   For Part A, two or more would be concurrent and so for Part B, two or more is considered a group. If you have a student working with you (the supervisor) with a group, either the student has to be overseeing the entire group, or you need to be overseeing the entire group. You can't split it, that's the big piece there. So let's say it's Part A, and you have four patients, I am overseeing two patients, and my student, Sally, is overseeing two patients, that's a no-no as well. Either I oversee all four, or Sally oversees all four. 


kathleen d weissberg

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L

Kathleen Weissberg, OTD, OTR/L, in her 25 years of practice, has worked in adult rehabilitation, primarily in long-term care as a clinician, manager, researcher, and most recently as Education Director with Select Rehabilitation where she oversees continued competency and education for close to 12,000 therapists. In her role, she conducts audits and provides denials management and quality improvement planning training for more than 700 LTC sites nationwide. She also conducts compliance, ethics, and jurisprudence training to therapists.  Kathleen has authored several publications that focus on patient wellness, fall prevention, dementia management, therapy documentation, and coding/billing compliance.  

 


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