Ron,

OPTIMAL was created by APTA.  This page has more info about OPTIMAL
http://www.apta.org/AM/Template.cfm?Section=Research&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=33241

See this update on AOTA's webpage about Transmittal 63:
http://www.aota.org/nonmembers/area1/links/link354.asp 

Transmittal 63 requires practitioners to include in their documentation of 
evaluations either the results of a specified performance measure tool or an 
explanation of certain factors. Specifically, the practitioner may report the 
results of one of the following measurement tools: the National Outcomes 
Measurement System (NOMS) by the American Speech-Language-Hearing Association; 
the Patient Inquiry* by Focus on Therapeutic Outcomes, Inc. (FOTO); the 
Activity Measure for Post-Acute Care (AM-PAC); or the Outpatient Physical 
Therapy Improvement in Movement Assessment Log (OPTIMAL) by Cedaron, through 
the American Physical Therapy Association.

If the practitioner chooses to not record the results of one of those four 
instruments, then the documentation must contain information

* supporting illness severity or complexity, 
* supporting medical care prior to the current episode, 
* required to indicate beneficiary health related to quality of life, 
* required to indicate beneficiary social support, and 
*required to indicate objective measurable beneficiary physical functioning. 

Transmittal 63 also contains additional policy clarifications and reiterates 
CMS' policies concerning billing for group outpatient therapy and for the 
services of therapy students in outpatient settings.

AOTA will be working with CMS to obtain clarification on aspects of 
Transmittals 1145 and 63. The development of an outcomes data measurement 
system focused on occupational therapy is an AOTA priority. In the interim, 
until such system can be implemented, AOTA is working internally and with CMS 
to develop mechanisms for occupational therapists to meet CMS' new 
documentation requirements.







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