N.J. Admin. Code § 8:85-2.4

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:85-2.4 - Rehabilitative services

(a) Rehabilitative services include physical therapy, occupational therapy and speech-language pathology services provided by a qualified therapist for the purpose of attaining maximum reduction of physical or mental disability and restoration of the resident to his or her best functional level. Rehabilitative services shall be made available to Medicaid beneficiaries as an integral part of an interdisciplinary program. Rehabilitative services shall not include physical medicine procedures administered directly by a physician, or physical therapy, which is purely palliative, such as the application of heat per se, in any form; massage; routine calisthenics or group exercises; assistance in any activity; use of a simple mechanical device; or other services not requiring the special skill of a qualified therapist.

1. If the attending physician orders an evaluation for physical, speech-language pathology services or occupational therapy, an appropriately qualified therapist shall perform an assessment to determine the need for services. The therapist shall complete a written report of therapy recommendations within 14 days of the physician's order and shall include the report in the clinical record, for review by the attending physician.

2. Rehabilitative treatment shall be provided under the direct supervision and in the presence of a qualified therapist or physiatrist, only upon the written signed order of the physician who shall indicate modality and frequency and duration of treatments. The attending physician shall evaluate each resident's response to therapeutic services on a monthly basis. Continuance of said services shall be based on documentation of a potential for significant functional improvement within a reasonable time frame.

i. Rehabilitation therapy services shall be integrated with medical, nursing, recreational and social services to promote development or restoration of the resident to his/her maximum potential and reviewed in conjunction with other periodic reviews of the interdisciplinary care plan.

3. Rehabilitative services shall be provided by qualified therapists employed by or under contract to:

i. An approved home health agency;

ii. A licensed or accredited general or special hospital;

iii. An approved independent outpatient health facility; or

iv. An NF.

N.J. Admin. Code § 8:85-2.4

Recodified from N.J.A.C. 10:63-2.4 and amended by R.2005 d.389, effective 1/17/2006.
See: 36 N.J.R. 4700(a), 37 N.J.R. 1185(a), 38 N.J.R. 674(a).
In introductory paragraph (a), added "or her" following "his" and substituted "beneficiaries" for "recipients".
Amended by R.2011 d.121, effective 4/18/2011.
See: 42 N.J.R. 1793(a), 43 N.J.R. 961(c).
In the introductory paragraph of (a), deleted a comma following "occupational therapy", and inserted a comma following "physical therapy"; in (a)3iv, substituted "An" for "A"; and deleted (a)4.