• Language on Standing Orders

    Question: My physician is looking for proof from Medicare that they do not allow standing orders in a practice setting. Can you provide me with the correct language?

    Answer: WPS, a Medicare Administrative Contractor, added this language to its webpage: “Routine orders are orders for those services and treatments that are applied to patients who have the same or similar medical condition(s). These frequently called ‘routine, protocol or standing orders’ are based on an assessment of the impact of a given condition in the population of patients with that condition (medical illness or injury) and are widely applied to those patients. Medicare defines any order(s) that does not specifically address an individual patient's unique illness, injury or medical status, as not reasonable and necessary. As is required by law, Medicare does not accept such ‘standing orders’ as supporting medical necessity for the individual patient. Services related to population-based or condition-based orders are not reimbursable.”

    Learn more about standing orders in Learn to Code the Essentials.