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Documenting Gait Training for Medicare Reimbursement

Coffman, Anne PT, MS, GCS

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Accurate documentation of gait training is essential for physical therapists and physical therapist assistants who provide services under Medicare. Gait refers to the manner of walking, whereas ambulation is the ability to walk. Recent government publications note the ways services do not meet Medicare guidelines and are thus not reimbursed as physical therapy. Skilled services may be provided when nonskilled services would be more appropriate. Skilled services may not be medically necessary. Staff purportedly providing skilled services may not have appropriate skill or experience. Maintenance therapy is not skilled therapy. Physical therapy services are considered reasonable and necessary when 4 requirements are met, namely, suitability for the particular diagnosis, need for skilled services, expectation that the condition will improve, and occurring in a reasonable time.

From the RehabCare Group, New Berlin, Wis.

Corresponding author: Anne Coffman, PT, MS, GCS, RehabCare Group, 12810 West Meadow Ln, New Berlin, WI 53151 (e-mail: amcoffman@aol.com).

© 2003 Lippincott Williams & Wilkins, Inc.