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LCD ID Number: L34430 Status: A-Approved
LCD Title: Respiratory Therapy (Respiratory Care)
Geographic Jurisdiction: Alabama Other Jurisdictions
Original Determination Effective Date:
10/01/2015
Original Determination Ending Date:
Revision Effective Date:
07/22/2021
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act, §1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member
Title XVIII of the Social Security Act, §1861(cc)(1) discusses Comprehensive Outpatient Rehabilitation Facility (CORF) services
Title XVIII of the Social Security Act, §1861(s)(2)(B) provides coverage of services incident to physicians services furnished to hospital patients
42 CFR §485.70 Comprehensive Outpatient Rehabilitation Facility (CORF) personnel qualifications- lists qualifications for respiratory therapists
CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 6, §20.4 Outpatient Diagnostic Services and §20.4.1 Diagnostic Services Defined
CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 8, §50.8.2 Respiratory Therapy
CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 12, §10 Comprehensive Outpatient Rehabilitation Facility (CORF) Services Provided by Medicare, §20 Required and Optional CORF Services, §20.1 Required Services, §20.2 Optional CORF Services, and §30 Rules for Provision of Services
CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 4, §240.7 Postural Drainage Procedures and Pulmonary Exercises and §240.8 Pulmonary Rehabilitation Services
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