Medicare Issues Memorandum Clarifying Orders for Outpatient Services

February 23, 2012

In response to concerns voiced by ASHA, other professional associations, and several hospital associations, the Centers for Medicare and Medicaid Services (CMS) issued a Memorandum Summary to state survey agency directors, clarifying that orders for outpatient services may be made by the practitioner who is responsible for the care of the patient, holds a recognized license in the jurisdiction where he or she sees the patient, acts within his or her scope of practice under state law, and is authorized, under a written hospital policy, to order outpatient treatment. This rescinds the language previously issued in Transmittal 72, which limited authority to issue orders to physicians with hospital privileges. The memorandum further states that it was not the intent of CMS to "...create access to care barriers or to limit the ability of practitioners who are appropriately licensed, acting within their scope of practice, and authorized under hospital policies to refer patients for outpatient services." The memorandum is expected to be posted later next week online on Policy and Memos to States and Regions.

For more information, questions, or concerns, please contact Lisa Satterfield, ASHA's director of health care regulatory advocacy, at

(Update to: New Medicare Guidelines Limit Physician Orders for Hospital Rehabilitation Patients)

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