Q: What is a skilled therapy service?
A: Skilled therapy service refers to the general principles governing reasonable and necessary physical therapy, speech-language pathology service, and occupational therapy, as outlined below:

The service of a physical, speech-language pathologist or occupational therapist is a skilled therapy service if the inherent complexity of the service is such that it can be performed safely and/or effectively only by or under the general supervision of a skilled therapist. To be covered, the skilled services must also be reasonable and necessary to the treatment of the patient's illness or injury or to the restoration of maintenance of function affected by the patient's illness or injury. It is necessary to determine whether individual therapy services are skilled and whether, in view of the patient's overall condition, skilled management of the services provided is needed although many or all of the specific services needed to treat the illness or injury do not require the skills of a therapist.

The development, implementation management and evaluation of a patient care plan based on the physician's orders constitute skilled therapy services when, because of the patient's condition, those activities require the involvement of a skilled therapist to meet the patient's needs, promote recovery and ensure medical safety. Where the skills of a therapist are needed to manage and periodically reevaluate the appropriateness of a maintenance program because of an identified danger to the patient, such services would be covered even if the skills of a therapist are not needed to carry out the activities performed as part of the maintenance program.

While a patient's particular medical condition is a valid factor in deciding if skilled therapy services are needed, the diagnosis or prognosis should never be the sole factor in deciding that a service is or is not skilled. The key issue is whether the skills of a therapist are needed to treat the illness or injury, or whether the services can be carried out by non skilled personnel.

A service that is ordinarily considered non skilled could be considered a skilled therapy service in cases in which there is clear documentation that, because of special medical complications, skilled rehabilitation personnel are required to perform or supervise the service or to observe the patient. However, the importance of a particular service to a patient or the frequency with which it must be performed does not, by itself, make a non-skilled service into a skilled service. *Source:Center for Medicare and Medicaid Services

Q: What is physical therapy?   
A: Physical therapy is a healthcare profession which provides services to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout life. This includes providing services in circumstances where movement and function are threatened by aging, injury, disease or environmental factors. Functional movement is a central element in what it means to be healthy. Source: Wikipedia

Q: What is occupational therapy?
A: Occupational therapy "Occupational therapy is as a profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by enabling people to do things that will enhance their ability to participate or by modifying the environment to better support participation." Source: World Federation of Occupational Therapists

Q: What is speech-language pathology?
A: Speech-language pathology is concerned with issues surrounding human speech and language communication disorders. There are multiple methods of human communication using all human senses both nonverbal communication (such as facial expression, posture, and gesture), and verbal communication. Speech and language pathology is primarily concerned with disorders of verbal communication, including expressive language (the production of effective communication) and receptive language (the understanding of presented communication). Speech results from voice production, and the manipulation of speech sounds creates language. Source: Wikipedia