Comprehensive Outpatient Rehabilitation Facility

The purpose of Comprehensive Outpatient Rehabilitation Facility (CORF) is to permit the beneficiary to receive multidisciplinary rehabilitation services at a single location in a coordinated fashion. A CORF’s or attending physician’s decision to discontinue coverage of outpatient rehabilitation services being provided to a Medicare beneficiary, results in termination of services. 

Prior to terminating a Medicare-covered rehabilitation service, the CORF will be required to deliver an advance notice to the Medicare beneficiary. The intent of an advance notice is to inform the patient of an end date for Medicare coverage of the rehabilitation service being provided, allowing time for an appeal if the patient disagrees with the coverage end date. Because of the advance notice, if an appeal were to be unsuccessful, the maximum financial liability for the patient should one day of services.

Detailed Notice of Medicare Non-Coverage
When CCME notifies a provider that a beneficiary has requested an expedited determination, the provider must send a detailed notice to the beneficiary by close of business of the day of the notification. The detailed termination notice must include the following information:

• A specific and detailed explanation why services are either no longer reasonable and necessary or are no longer covered.
• A description of any applicable Medicare coverage rule, instruction, or other Medicare policy, including citations to the applicable Medicare policy rules or information about how the beneficiary may obtain a copy of the Medicare policy.
• Facts specific to the beneficiary and relevant to the coverage determination that are sufficient to advise the beneficiary of the applicability of the coverage rule or policy to the beneficiary's case.
• Any other information required by CMS.

For more information on CORFs, visit the CMS website.