Free tool · Medicare outpatient therapy
Plan of care date calculator
Know when the plan must be certified, when to recertify and which visit needs a progress report, so no claim is denied over a missed signature.
Your patient’s dates
Enter the first treatment day.
Recertify sooner if the plan of care ends before 90 days or changes significantly. If a certification is late, Medicare accepts a delayed certification with an explanation of the delay.
Runs in your browser. Dates are counted in calendar days.
Why these dates cause denials
Missing certifications and progress reports are among the documentation errors CMS lists for outpatient therapy. In a 2018 audit, the HHS Office of Inspector General found that 61% of sampled outpatient physical therapy claims did not meet Medicare requirements. Read the OIG report.
Questions
When must a therapy plan of care be certified?
CMS considers certification timely when the physician or non-physician practitioner signs the plan within 30 days of the first treatment day. A late certification can still be accepted with an explanation of the delay.
How often must a plan of care be recertified?
At least every 90 calendar days, or sooner when the plan ends before then or when it changes significantly.
How often is a progress report required?
At least once every 10 treatment days. A treatment day is a day on which a billable therapy service is provided.
Do verbal orders need a signature?
Yes. CMS asks that verbal orders be documented and signed by the ordering practitioner within 14 days.
This tool gives information, not billing or legal advice. Check dates against your Medicare Administrative Contractor’s guidance.