Coverage of Rec. Therapy -- Book Review.

I recently read Tim Passmore’s “Coverage of Recreational Therapy: Rules and Regulations” (2nd ed.). This book is published by the American Therapeutic Recreation Association (ATRA). All profits from this book to to ATRA. Passmore does not receive any.

I admire Tim Passmore and what he is doing to advocate for the profession. Recreational therapists need to know what the requirements are to assure coverage of services.

Here is an example:

I work in an inpatient psychiatric hospital setting. Passmore points out the requirements for “active treatment” that are outlined in the Medicare Benefit Policy Manual. One requirement is a physician’s order for treatment.

I first learned of this requirement when I had attended a session "on coverage" by Passmore at the 2009 ATRA conference in Minneapolis, Minnesota. I immediately went back to work and checked into this. I discovered we do have a standard order for all admissions (where I work at -- in one of the two Virginias).

Basically, our order is a checklist of therapies to be provided such as: individual therapy, Therapeutic Recreation/ Education (TR/Ed), and others. It is checked off (usually by an admission nurse) and the physician signs it. Of course, the physician can always write an order for other interventions when needed, too, such as: Community Re-entry outing.

Many of the requirements for “active treatment” are the same as the standards of practice for our profession, including: conduct assessment, work with patient/ client to develop an individualized treatment plan, provide interventions to assist the patient in meeting her (or his goals), evaluate outcomes, and form a discharge summary at the time of discharge.

Naturally, active treatment requires the goals to address areas of functional improvement. Here is an important concept: Simply providing recreation activities in a clinical or hospital setting does not constitute as “therapy” or in this case “active treatment.”

Don’t get me wrong. I think recreation is great! My undergraduate degree is in Park Resources and Leisure Services. Of course, I have an emphasis in Therapeutic Recreation. I think recreation activities are great! I also realize that simply providing an activity like “Bingo” or “DVD Movie” in a hospital setting isn’t Recreational Therapy. It is just divisional activities.

I think activities for diversion is great! However, these activities wouldn’t be covered under “active treatment” in the Medicare policies manual.

Be sure to get a copy of this book to make sure you’re in alignment with requirements for coverage for your setting. Passmore covers the required steps for inpatient physical rehabilitation and inpatient psychiatric hospital facilities.

Here is the link for the book: http://www.atra.affiniscape.com/storelistitem.cfm?itemnumber=1