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CMS-1403-FC “physical therapy services” to include speech-language pathology services because the statutory definition of “outpatient physical therapy services” (section 1861(p) of the Act) included speech-language pathology services (66 FR at 925). To conform the language of the regulations to MIPPA, we are revising two of the definitions at §411.351. First, we are revising the definition of “Designated health services (DHS)” by adding the word “outpatient” before the phrase “speech-language pathology services” in paragraph (2). Second, we are revising the definition of “Physical therapy, occupational therapy, and speech-language pathology services” by: ● Removing the phrase “speech-language pathology” in the heading of the definition and wherever it occurs within the introductory paragraph and adding, in its place, the phrase “outpatient speech-language pathology”; ● Deleting the parenthetical “(including speech-language pathology services)” from paragraph (1) of the description of physical therapy services; ● Deleting sub-paragraph (1)(iv), which describes physical therapy services as including “Speech-language pathology services that are for the diagnosis and treatment of speech, language, and cognitive disorders that include swallowing and other oral-motor dysfunctions;” and 936
CMS-1403-FC ● Adding the following new paragraph to describe outpatient speech-language pathology services: “(3) Outpatient speech-language pathology services, meaning those services as described in section 1861(ll)(2) of the Act that are for the diagnosis and treatment of speech, language, and cognitive disorders that include swallowing and other oral-motor dysfunctions”. Consistent with the provisions of section 143 of the MIPPA, these changes will be effective July 1, 2009. C. Annual Update to the Code List 1. Background In §411.351, we specify that the entire scope of four DHS categories is defined in a list of CPT/HCPCS codes (the Code List), which is updated annually to account for changes in the most recent CPT and HCPCS publications. The DHS categories defined and updated in this manner are: ● Clinical laboratory services. ● Physical therapy, occupational therapy, and outpatient speech-language pathology services. ● Radiology and certain other imaging services. ● Radiation therapy services and supplies. The Code List also identifies those items and services that may qualify for either of the following two exceptions to the physician self-referral prohibition: 937
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<strong>CMS</strong>-1403-FC<br />
“physical therapy services” to include speech-language<br />
pathology services because the statutory definition of<br />
“outpatient physical therapy services” (section 1861(p) of<br />
the Act) included speech-language pathology services (66 FR<br />
at 925). To conform the language of the regulations to<br />
MIPPA, we are revising two of the definitions at §411.351.<br />
First, we are revising the definition of “Designated health<br />
services (DHS)” by adding the word “outpatient” before the<br />
phrase “speech-language pathology services” in paragraph<br />
(2). Second, we are revising the definition of “Physical<br />
therapy, occupational therapy, and speech-language<br />
pathology services” by:<br />
● Removing the phrase “speech-language pathology” in<br />
the heading of the definition and wherever it occurs within<br />
the introductory paragraph and adding, in its place, the<br />
phrase “outpatient speech-language pathology”;<br />
● Deleting the parenthetical “(including<br />
speech-language pathology services)” from paragraph (1) of<br />
the description of physical therapy services;<br />
● Deleting sub-paragraph (1)(iv), which describes<br />
physical therapy services as including “Speech-language<br />
pathology services that are for the diagnosis and treatment<br />
of speech, language, and cognitive disorders that include<br />
swallowing and other oral-motor dysfunctions;” and<br />
936