the United States that are accredited by such 
an accreditation agency. 
‘‘(2) With respect to individuals licensed as 
physical therapists by a State before 2005, the indi-
vidual was, or upon application to the Secretary 
could have been, qualified under regulations of the 
Secretary in effect before such date to furnish phys-
ical therapy services under this title, as determined 
by the Secretary.’’. 
(b) PRESERVING EXISTING LAW FOR OUTPATIENT 
OCCUPATIONAL THERAPY SERVICES.— 
(1) DEFINITION.—Section 1861(g) of the Social 
Security Act (42 U.S.C. 1395x(g)) is amended to 
read as follows: 
‘‘Outpatient Occupational Therapy Services 
‘‘(g) The term ‘outpatient occupational therapy serv-
ices’ means occupational therapy services furnished by a 
provider of services, a clinic, a rehabilitation agency, or 
a public health agency, or by others under an arrangement 
with, and under the supervision of, such a provider, clinic, 
rehabilitation agency, or public health agency to an indi-
vidual as an outpatient— 
‘‘(1) who is under the care of a physician (as 
defined in paragraph (1), (3), or (4) of subsection 
(r)); 
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‘‘(2) with respect to whom a plan prescribing 
the type, amount, and duration of occupational ther-
apy services that are furnished to such individual 
has been established by a physician (as so defined) 
or by an occupational therapist and is periodically 
reviewed by a physician (as so defined); 
excluding, however— 
‘‘(3) any item or service if it would not be in-
cluded under subsection (b) if furnished to an inpa-
tient of a hospital; and 
‘‘(4) any such service— 
‘‘(A) if furnished by a clinic, rehabilitation 
agency, or by others under arrangements with 
such clinic or agency, unless such clinic or reha-
bilitation agency— 
‘‘(i) provides an adequate program of 
occupational therapy services for out-
patients and has the facilities and per-
sonnel required for such program or re-
quired for the supervision of such a pro-
gram, in accordance with such require-
ments as the Secretary may specify; 
‘‘(ii) has policies, established by a 
group of professional personnel, including 
one or more occupational therapists, to 
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govern the services (referred to in clause 
(i)) it provides; 
‘‘(iii) maintains clinical records on all 
patients; 
‘‘(iv) if such clinic or agency is situ-
ated in a State in which State or applica-
ble local law provides for the licensing of 
institutions of this nature— 
‘‘(I) is licensed pursuant to such 
law, or 
‘‘(II) is approved by the agency 
of such State or locality responsible 
for licensing institutions of this na-
ture, as meeting the standards estab-
lished for such licensing; and 
‘‘(v) meets such other conditions relat-
ing to the health and safety of individuals 
who are furnished services by such clinic or 
agency on an outpatient basis, as the Sec-
retary may find necessary, and provides 
the Secretary on a continuing basis with a 
surety bond that is not less than $50,000; 
or 
‘‘(B) if furnished by a public health agen-
cy, unless such agency meets such other condi-
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tions relating to the safety of individuals who 
are furnished services by such agency on an 
outpatient basis, as the Secretary may find nec-
essary. 
The term ‘outpatient occupational therapy services’ also 
includes occupational therapy services furnished an indi-
vidual by an occupational therapist (in the office of the 
occupational therapist or in such individual’s home) who 
meets licensing and other standards prescribed by the Sec-
retary in regulations, otherwise than under an arrange-
ment with and under the supervision of a provider of serv-
ices, clinic, rehabilitation agency, or public health agency, 
if the furnishing of such services meets such conditions 
relating to health and safety as the Secretary may find 
necessary. In addition, such term includes occupational 
therapy services that meet the requirements of the first 
sentence of this subsection except that they are furnished 
to an inpatient of a hospital or extended care facility. 
Nothing in this subsection shall be construed as requiring, 
with respect to outpatients who are not entitled to benefits 
under this title, an occupational therapist to provide out-
patient occupational therapy services only to outpatients 
who are under the care of a physician or pursuant to a 
plan of care established by a physician. The Secretary may 
waive the requirement of a surety bond under paragraph 
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(4)(A)(v) in the case of a clinic or agency that provides 
a comparable surety bond under State law.’’. 
(2) CONFORMING AMENDMENTS.— 
(A) 
SCOPE
OF
BENEFITS.—Section 
1832(a)(2)(C) of the Social Security Act (42 
U.S.C. 1395k(a)(2)(C)) is amended by striking 
‘‘such sentence applies through the operation of 
section 1861(g))’’ and inserting ‘‘the second 
sentence of section 1861(g) applies)’’. 
(B) PAYMENT
OF
BENEFITS.—Section 
1833(g)(3) of the Social Security Act (42 
U.S.C. 1395l(g)(3)) is amended by striking 
‘‘section 1861(p)’’ and all that follows through 
‘‘section 
1861(g)’’ 
and 
inserting 
‘‘section 
1861(g) (but not described in subsection 
(a)(8)(B))’’. 
(C) PROVIDER CLAIMS PROCEDURES.—The 
second sentence of section 1835(a) of the Social 
Security Act (42 U.S.C. 1395n(a)) is amend-
ed— 
(i) by striking ‘‘section 1861(p)(4)(A) 
(or meets the requirements of such section 
through the operation of section 1861(g))’’ 
and inserting ‘‘section 1861(p)(4)(A) or 
section 1861(g)(4)(A)’’; 
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