Out-Patient Physical Therapy/Speech Pathology

There are three types of organizations that may qualify as OPT/OSP providers:

1. Rehabilitation Agency - An agency that provides an integrated, multidisciplinary program designed to upgrade the physical functions of handicapped, disabled individuals by bringing together, as a team, specialized rehabilitation personnel.
2. Clinic- A facility established primarily for the provision of outpatient physicians’ services.  To meet the definition of a clinic, the facility must meet the following test of physician participation:
   • The medical services of the clinic are provided by a group of three or more physicians practicing medicine together; and
   • A physician is present in the clinic at all times during hours of operation to perform medical services (rather than only administrative services).
3. Public Health Agency - An official agency established by a State or local government, the primary function of which is to maintain the health of the population served by providing environmental health services, preventive medical services, and in certain instances, therapeutic services.

OPT-SP-OTS Facility Medicare Certification

For information on filing a complaint or checking the status of a current complaint, please visit our complaint section. 

The health care provider shall complete the IDPH “Facility Information Change Form” prior to the relocation and submit to the Department.  If the Health Care Provider is Medicare certified then the provider shall also complete Medicare Provider enrollment form A and submit to their Medicare fiscal intermediary.

Refer to the Medicare Regulations under Chapter 2 of the State Operations Manual.
 
An extension location is defined at 42 CFR 485.703 as “a location or site from which a rehabilitation agency provides services within a portion of the total geographic area served by the primary site. The extension location is part of the agency. The extension location should be located sufficiently close to share administration, supervision, and services in a manner that renders it unnecessary for the extension location to independently meet the conditions of participation as a rehabilitation agency.”  The provider shall complete the “Extension Site Form” found under “Forms” and mail it to the Department for review and recommendation to The Center for Medicare and Medicaid Services for approval.

• File a Complaint
• IL Compiled Statutes
• Medicare Chapter 2- Certification Process

• Medicare Intermediary Information
• OPT-SP-OTS Facility Medicare Certification
• Extension Site Checklist

• Medicare Out-Patient Physical Therapy/Speech Pathology Manual