HI 00610.380 Outpatient Occupational Therapy Services

Outpatient occupational therapy services are covered under Part B only under the outpatient hospital benefit, the home health benefit, or as part of CORF services. These services are subject to the Part B deductible. In addition, outpatient hospital services and CORF services are subject to the 20 percent coinsurance.

Medicare will pay for occupational therapy services provided to a beneficiary under these benefits if the services are prescribed by a physician, performed by a qualified occupational therapist or a qualified occupational therapy assistant under the general supervision of a qualified occupational therapist, and are reasonable and necessary for the treatment of the beneficiary's illness or injury. Payment may also be made for the cost of supplies, e.g., looms, ceramic tiles, leather, which the occupational therapist uses in the course of therapy.