Progress Reports: What are the Required Elements?

May 9, 2016
Rick Gawenda

In last weeks article, Reevaluations vs Progress Reports: What’s the Difference?, I explained the difference between a reevaluation and a progress report, how the 2 terms are not the same and should not be used interchangeably and when a reevaluation is appropriate to perform and bill to an insurance carrier. This week, I want to discuss what the required elements are for a progress report under Medicare Part B as well as some private/commercial insurance carriers and how often they are required by the Medicare program.

Under Medicare Part B, the Centers for Medicare and Medicaid Services (CMS) states the minimum progress reporting period shall be at least once every

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  1. Thank you for spelling out the required components of the progress reports, succinctly.
    What options are there in this scenario…. Therapist begins the progress report and ends employment without completing the progress report. Patient was seen for additional dates of service after the date of the progress report.
    Can another therapist complete the note using information that has been documented in the record? includes assigning G codes.
    Or other options?
    Thank you!

    1. That would depend on how comfortable the therapist would feel in writing a progress report based on a patient they have not seen or treated.

  2. The 2012 CMS guide for physical, occupational, and speech therapy services states: “the end of the progress reporting period is:
    -A date chosen by the clinician
    -the 10th treatment day or
    -the 30th calendar day of the episode of treatment
    which ever is shorter.”

    I haven’t seen anyone else mention the 30 days, or whichever is sooner. Did they change their requirements since 2012? We have always followed the 10 visit rule.