---
kind: "section"
citation: "42 C.F.R. § 410.61"
title: "42"
number: "410.61"
heading: "Plan of treatment requirements for outpatient rehabilitation services."
url: "https://uscodex.org/cfr/42/410.61"
---

# §410.61. Plan of treatment requirements for outpatient rehabilitation services.

- (a) **Basic requirement.** Outpatient rehabilitation services (including services furnished by a qualified physical or occupational therapist in private practice), must be furnished under a written plan of treatment that meets the requirements of [paragraphs (b) through (e)](#b..e) of this section.
- (b) **Establishment of the plan.** The plan is established before treatment is begun by one of the following:
  - (1) **A physician.**
  - (2) **A physical therapist who furnishes the physical therapy services.**
  - (3) **A speech-language pathologist who furnishes the speech-language pathology services.**
  - (4) **An occupational therapist who furnishes the occupational therapy services.**
  - (5) **A nurse practitioner, a clinical nurse specialist, or a physician assistant.**
- (c) **Content of the plan.** The plan prescribes the type, amount, frequency, and duration of the physical therapy, occupational therapy, or speech-language pathology services to be furnished to the individual, and indicates the diagnosis and anticipated goals.
- (d) **Changes in the plan.** Any changes in the plan—
  - (1) **Are made in writing and signed by one of the following—**
    - (i) **The physician.**
    - (ii) **The physical therapist who furnishes the physical therapy services.**
    - (iii) **The occupational therapist that furnishes the occupational therapy services.**
    - (iv) **The speech-language pathologist who furnishes the speech-language pathology services.**
    - (v) A registered professional nurse or a staff physician, in accordance with oral orders from the physician, physical therapist, occupational therapist, or speech-language pathologist who furnishes the services.
    - (vi) **A nurse practitioner, a clinical nurse specialist, or a physician assistant.**
  - (2) **The changes are incorporated in the plan immediately.**

## Notes

### Amendments

[53 FR 6638, Mar. 2, 1988; 53 FR 12945, Apr. 20, 1988, as amended at 54 FR 38680, Sept. 20, 1989; 54 FR 46614, Nov. 6, 1989. Redesignated at 56 FR 8854, Mar. 1, 1991; 56 FR 23022, May 20, 1991; 63 FR 58907, Nov. 2, 1998; 67 FR 80040, Dec. 31, 2002; 72 FR 66399, Nov. 27, 2007; 77 FR 69363, Nov. 16, 2012; 83 FR 60073, Nov. 23, 2018]

### Authority

Authority: 42 U.S.C. 1302, 1395m, 1395hh, 1395rr, and 1395ddd.

### Source

Source: 51 FR 41339, Nov. 14, 1986, unless otherwise noted.

### Amendments

[53 FR 6638, Mar. 2, 1988; 53 FR 12945, Apr. 20, 1988, as amended at 54 FR 38680, Sept. 20, 1989; 54 FR 46614, Nov. 6, 1989. Redesignated at 56 FR 8854, Mar. 1, 1991; 56 FR 23022, May 20, 1991; 63 FR 58907, Nov. 2, 1998; 67 FR 80040, Dec. 31, 2002; 72 FR 66399, Nov. 27, 2007; 77 FR 69363, Nov. 16, 2012; 83 FR 60073, Nov. 23, 2018]