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The only specific CMS reference for content and timing of therapy progress notes refers to the Medicare Part B 10th Visit Progress Report. The Medicare Benefit Policy Manual (Chapter 15, Section 220.3.D) outlines this requirement and clarifies what an assistant can and cannot document. There is no specific requirement for a weekly progress note in Medicare Part A – this has simply been an industry standard for many years. Chapter 8 of the Medicare Benefit Policy Manual, Section 30.2.2.1 addresses coverage and documentation requirements for SNF Part A, but simply states that the medical record must demonstrate that services are skilled and medically necessary. If the content of a weekly progress note for a Medicare Part A patient includes an assessment of the patient’s progress/status and modifications to the goals or treatment plan, then Medicare is clear in Chapter 15 that this falls outside the scope of what an assistant can do and document.

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