skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
En Español
Text Size:
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 6/29/2020 Location: FL, PR, USVI Business: Part A, Part B

Reimbursement for CORF versus ORF FAQ

Q: Are there any physical therapy services that are considered reimbursable in a comprehensive outpatient rehabilitation facility (CORF) setting but are not considered reimbursable in an outpatient rehabilitation facility (ORF) setting?
A: No, however ORFs and CORFs are different provider types and submit claims on different types of bills. In addition, they are not part of an outpatient hospital therapy department.
An ORF is defined as a provider of service with an agreement to furnish outpatient therapy services to beneficiaries. The services must be reasonable and necessary with a potential for improvement. Only restoration therapy is covered. The beneficiary must be under the care of a physician. The facility agrees that they will not charge the beneficiary for covered services that Medicare should pay. ORFs use a 74x type of bill when submitting claims to Medicare.
A CORF is a facility that is primarily engaged in providing diagnostic, therapeutic and restorative services to outpatients for the rehabilitation of the injured and disabled or patients recovering from an illness. The CORF must provide a comprehensive, coordinated skilled rehabilitation program for its patients that include, at minimum, CORF physicians’ services, physical therapy services, and social or psychological services. The facility must have adequate space and equipment necessary for any of the services provided. In general, all services must be furnished on the premises of the CORF. The only exception is home evaluations. CORFs use a 75x type of bill when submitting claims to Medicare.
Another difference between CORFs and ORFs
For a CORF, the referring physician must review the plan of treatment every 60 days. However, an ORF must have the physician certify the plan of care every 90 days. For outpatient hospital-based therapy departments, re-certification for therapy should be performed every 90 days; however, it is acceptable for re-certification to be performed every 60 days.
list item Please use your browser's back button to return to the referring page.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.