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What Has to Be on a Physician Order

by • August 6, 2018 • 10 Comments

I am often asked what items must be on a physician order for a patient referred to outpatient physical, occupational and/or speech therapy services. Can a physician or other qualified practitioner just write “Evaluate and Treat”? Must the physician or practitioner list a frequency and duration on the order? As you can imagine, the answer is not simple.

To determine what items must be on a physician/practitioner order for a patient referred to outpatient physical, occupational and/or speech therapy services, you must look at your state practice act, the contract you signed with the insurance carrier as well as the insurance carriers’ therapy policies. Do any of those 3 list what is required on a physician/practitioner order for outpatient therapy services? If yes, follow the requirements of the one that is most restrictive.

The majority of state practice acts do not list what must be documented on a physician/practitioner order. When I read the Aetna, Cigna and UnitedHealthcare online therapy policies,

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10 thoughts on “What Has to Be on a Physician Order”

  1. Ron Ryskalczyk says:

    What does CMS require?

    1. Rick Gawenda says:

      CMS does not require an order for outpatient therapy services. CMS requires a signed and dated plan of care by the physician and therapist.

      1. Maly Copeland says:

        Yes, but then you will have to find a doctor willing to sign the plan of care. We require an order at my clinic because this guarantees a doctor will sign the plan of care.

        1. Rick Gawenda says:

          Perhaps it guarantees, but not necessarily. I have seen some physicians not sign the plan of care as they state the physician order should suffice.

  2. Jim Milani says:

    An MD and NNP can write and order and sign the POC. Can a podiatrist, dentist and chiropractor also write and sign the POC?

    1. Rick Gawenda says:

      Please read my FAQs on this topic. Scroll down to February 27, 2015.

      Here is an article I published June 5, 2018:

  3. Gayle Hove says:

    In the InPatient setting, who can sign a PT order? If it is a verbal order, how long does the Ordering practitioner have to co-sign it?

    1. Rick Gawenda says:

      You would need to check with your hospital policies regarding inpatient orders.

  4. Thomas Murray says:

    In pure hospital / acute care / unit based settings (not same day/extended recovery part B services), do physicians need to sign the POC prior to the patient d/c?

    1. Rick Gawenda says:


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