NEWS RELEASE

Contact: Laurie Jake, ATRA Communications Coordinator
Phone (480) 460-1525 or
Ann D Huston MPA, CTRS
Phone: (703) 683-9420

Medicare and Recreational Therapy- AdminaStar Includes RT In Definition Of Skilled Service

(Alexandria, VA) The American Therapeutic Recreation Association is excited to announce the successful achievement of yet another important recognition within the Centers for Medicare and Medicaid Services (CMS). AdminaStar, one of the agencies that work with CMS to administer Medicare programs in several states, including working with the fiscal Intermediaries announced that it plans to include recreational therapy in the definition of a skilled service.

AdminaStar requested public comment regarding the Local Medical Review Policies, and ATRA’s leadership team, shared this information with ATRA members in the states affected by these policies. ATRA members was actively involved in providing comments to AdminaStar regarding the Local Medical Review Policies (LMRP's) including information about recreational therapy services. AdminaStar solicits comments from the provider community and from members of the public who may be affected by or interested in our LCDs. The purpose of the advice and comment process is to gain the expertise and experience of those commenting. AdminaStar posted their "Comments and Responses Regarding Draft Local Coverage Determination: Inpatient Rehabilitation Services Provided in Inpatient Rehabilitation Facilities" on their website (WWW.ADMINASTAR.COM)

Administar’s comments include an RT comment/response, stating” Upon review of the information provided as well as additional literature, we have included therapeutic recreation as an example of skilled rehabilitation services based on the individual patient’s needs. Although previous criteria did not exclude therapeutic recreation, the fact that it was not mentioned by name and other disciplines were could lead providers to believe that therapeutic recreation services could not constitute skilled services when provided in the context of inpatient rehabilitation.

ATRA is pleased with the additional positive clarification of recreational therapy services. Last August, CMS stated in the federal register “"Neither the implementation of the prospective payment system nor the criteria for excluding certain hospitals and units from it will prohibit the provision of recreational therapy services to hospital inpatients.” CMS further clarified, “ Since the publication of the January 3, 1984 final rule, we have not made any changes to our policies that would preclude recreational therapy services from those covered by Medicare. In particular the introduction of the IRF PPS does not change this fact. Accordingly, since recreational therapy services were provided in the IRF base period, the costs of providing these covered services are included in standardized payment amount upon which the IRF PPS rates are based.”

For more information, please contact the ATRA National Office at (703) 683-9420 or at www.atra-tr.org .

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The American Therapeutic Recreation Association (ATRA) was founded in 1984 to advance the profession of therapeutic recreation. ATRA is a non-profit, professional membership organization dedicating 100% of resources and efforts to promote therapeutic recreation professionals in health care and human service settings. For more information, please contact the ATRA National Office.