What Determines When a Progress Report Is Due?​

Several factors influence how RehabAlpha calculates Progress Report due dates:

• Payor

  • Medicare Part A
  • Medicare Part B
  • Managed Medicare
  • Commercial Insurance
  • Medicaid (state-specific)

• Facility / Setting

  • Skilled Nursing Facility (SNF)
  • Inpatient Rehabilitation Facility (IRF)
  • Outpatient / Private Practice
  • Home Health

• Discipline

  • Physical Therapy
  • Occupational Therapy
  • Speech-Language Pathology

RehabAlpha evaluates these inputs to determine:

• When a Progress Report is due
• Which encounters count toward that requirement

Do MACs or LCDs affect timing?​

No.
Local Coverage Determinations (LCDs) and Medicare Administrative Contractors (MACs) may affect what must be documented, but they do not change when a Progress Report is due. Timing is set nationally by CMS.

Skilled Nursing Facilities (SNF)​

Medicare Progress Report Timing (CMS Federal Rule)​

CMS defines a Progress Report Period as:

At least once every 10 treatment days or once every 30 calendar days, whichever occurs first.

This requirement applies nationally and does not vary by state.

Reference:
Medicare Benefit Policy Manual, Chapter 15

When does the clock start?​

The reporting period begins on the first day of the episode of treatment, regardless of whether that day includes:

• An evaluation
• A re-evaluation
• A treatment visit

In RehabAlpha, this is typically the evaluation start date for a therapy case.

When does the first reporting period end?​

The first reporting period ends when any one of the following occurs:

1. A Progress Report is completed
2. 10 treatment days have occurred
3. 30 calendar days have elapsed

Whichever comes first.

Examples​

Assume a PT evaluation occurs on January 1, 2025.

Scenario 1: No follow-up visits​

• No treatments occur after the evaluation
• Calendar-day clock continues
• Reporting period ends at 11:5PM on January 30
• Progress report is due within 7 days of the end of the period (by 11:59PM on February 6)

Scenario 2: Low-frequency treatment (2x/week)​

• Fewer than 10 treatment days occur
• 30 calendar days occurs first
• Reporting period ends at 11:5PM on January 30
• Progress report is due within 7 days of the end of the period (by 11:59PM on February 6)

Scenario 3: High-frequency treatment (5x/week)​

• 10th treatment day occurs on Jan 12 (before 30 calendar days)
• Reporting period ends at 11:5PM on January 12
• Progress report is due within 7 days of the end of the period (by 11:59PM on January 19)

Scenario 4: Early Progress Report​

• A Progress Report is completed on January 7 (before 10 tx days and 30 calendar days)
• The reporting period ends on January 7
• The next reporting period does not begin until the next treatment day

Subsequent Reporting Periods​

After a reporting period ends:

• The next reporting period begins on the next treatment day
• There may be gaps between reporting periods if no treatment occurs
• Calendar days during gaps do not count toward a reporting period until treatment resumes

Key Clarifications​

What is a “treatment day”?​

A treatment day is any calendar day in which billable skilled therapy is provided.

• RehabAlpha only counts days on which a treatment occurs
• RehabAlpha does not count evaluations and re-certifications unless a treatment also occurs on the same day
• RehabAlpha does not count missed or canceled treatments, even if scheduled

Multiple visits in one day​

• Multiple treatments on the same calendar day count as one treatment day

Patient absences​

• Absences do not pause the 30-day clock
• A Progress Report may still be due even if the patient is absent near the end of the period

Time zone​

• All timing is calculated using the facility’s local time zone

Medicare Part A vs Part B Differences​

Medicare Part A (Bundled)​

• Treatment days are counted once per calendar day if any skilled therapy occurs on that date
• Discipline does not matter
• When the reporting period ends, each discipline involved must complete a Progress Report

Medicare Part B (Fee-for-Service)​

• Treatment days are counted separately for each discipline
• PT, OT, and SLP each have independent reporting periods

State Rules and Facility Policies​

CMS does not allow states to override Medicare Progress Report timing.

However:

• Some state practice acts
• Some facility or corporate compliance policies
• Some non-Medicare payors

may require earlier or more frequent progress documentation.

RehabAlpha allows these stricter rules to be configured, but they are not Medicare requirements.

State requirments​

Some states have progress report timing rules that are stricter than CMS...

todo: check if this is correct. Find a source

Physical Therapy​

Occupational Therapy​

Speech-Language Pathology​

Common Edge Cases RehabAlpha Handles​

• Mid-episode payor changes (e.g., Part A → Part B)
• Multiple disciplines treating the same patient
• Missed or skipped treatment days
• Early Progress Reports
• Documentation completed without same-day patient contact
• Facility-specific stricter documentation policies

How does RehabAlpha handle upcoming and overdue progress reports?​

todo: discuss notices

Questions or Corrections?​

If you have questions, believe a rule is being applied incorrectly, or notice a regulatory change:

📧 support@rehabalpha.com

We actively update our logic to reflect evolving guidance and appreciate feedback from clinicians and administrators.

You might be surprised to hear that before building RehabAlpha, I had zero experience in healthcare. My background is in mathematics and computer science, and I started my career as a data scientist before transitioning into software engineering.

How RehabAlpha Started​

It all began when a friend of a friend told me his rehab therapy clinic was losing its software provider — Casamba was shutting down. I was intrigued. Then I learned the main alternative was Net Health, and therapists really don’t like it. That’s when I got obsessed.

I spent months talking to therapists, directors of rehab, and clinic staff. I listened, took notes, asked dumb questions, and learned a lot. Meanwhile, I started building — writing code for something better, faster, and friendlier to use.

A year later, RehabAlpha has come a long way. But there's still plenty of work ahead.

A Few Hot Takes​

Here are some of my stronger opinions about rehab therapy software — feel free to disagree (or agree loudly):

• Rehab software should be made by software people learning healthcare — not the other way around.
• Customizability is usually overrated. It breeds bloat, bugs, and slow performance.
• Plain language beats jargon: say occupational therapist instead of OT, treatment instead of tx, and so on.
• Great software has great docs. No exceptions.

I Need Your Help​

If you’re a therapist, rehab director, clinic owner, billing specialist, or just someone curious — I’d love to hear from you.

I’m especially looking for:

• Beta testers
• Feedback
• Customers
• Partners
• Ideas

If you're an investor: I’m not raising money right now — expenses are low, and I’m staying lean. But I’m open to a conversation, especially if you bring more than capital: introductions, customers, strategy — that kind of help.

Let’s make rehab software better.

Mar 2026​

• Added full event support inside therapy case timelines, including event cards, editing from the timeline, and the ability to create events directly from the case page
• Improved the schedule and timeline experience, including clearer treatment titles and better visual separation between events and treatments
• Added clock in / clock out functionality to the timesheet panel and improved time tracking throughout the app
• Improved audit trail support by strengthening user session tracking and timesheet verification
• Expanded and improved the custom form system used across clinical documentation, making forms more flexible and reliable
• Added more powerful conditional logic for custom forms, allowing organizations to build smarter forms that better adapt to discipline, setting, payor, and other context
• Improved required-field validation for custom forms so missing required items are caught more reliably before save
• Improved handling of “none” and unanswered values in custom forms, helping forms behave more consistently and reducing confusion
• Expanded support for Medicare PDPM workflows, including fixes and improvements to suggestions, form behavior, and schema alignment
• Added an Apply all suggestions action for PDPM assessments to speed up documentation
• Improved AI-powered suggestions across documentation, including better handling of diagnoses, service logs, and suggested value labels
• Reduced duplicate or unnecessary context in AI prompts, helping suggestions stay more focused and relevant
• Improved the schema editor and schema documentation, making it easier to build and maintain custom forms
• Added more schema examples, tutorials, FAQs, and tips in the documentation
• Improved the organization setup and demo/test data tools, making it easier to generate realistic sample organizations, facilities, patients, and related data
• Improved loading states and progress indicators so the app feels clearer and more responsive during navigation and saving
• Replaced some confusing Cancel buttons with Back buttons to make navigation more intuitive
• Improved handling of browser autofill edge cases, including phone number formatting and unwanted autofill behavior
• Fixed a variety of custom form rendering bugs, validation issues, and edge cases that could affect clinical documentation workflows
• Fixed several timezone-related bugs and improved date/time handling in different parts of the app
• Fixed additional bugs affecting AI suggestions, service logs, timelines, sign-in flows, and smaller UI details
• Continued improving overall performance, reliability, and usability throughout the app

Feb 2026​

• Introduced a powerful custom data + schema system, enabling fully customizable forms across cases, evaluations, treatments, and all related documents
• Replaced legacy assessment architecture with custom data-driven schemas, simplifying the model and unlocking significantly more flexibility
• Added schema versioning and validation, including stricter enforcement in cloud functions and safeguards against invalid or cyclic configurations
• Implemented conditional logic enhancements, including else branches, additional operators, special variables (e.g., discipline, facility, template, payor), and prevention of invalid data persistence from false branches
• Expanded schema capabilities with new node types (date, time, grouped fieldsets) and richer input support (nullable numbers, deselectable radios, object-based select options)
• Enabled template customization at the organization level, including default templates, case-specific templates, and improved template selection UX
• Added CodeMirror-powered schema editor and significantly expanded documentation, including full schema guides and advanced logic explanations
• Improved AI integration with custom data, including better handling of radio inputs, prevention of overwrites, and more accurate, context-aware suggestions
• Refactored and modularized Zod schema architecture, improving maintainability without changing behavior
• Enhanced form rendering performance, including reduced re-renders and more efficient fieldset handling
• Improved form UX and consistency, including simplified components, better layout of custom data fieldsets, and improved navigation (including right-side nav support for grouped fields)
• Strengthened cloud function reliability, including schema validation, new triggers (e.g., on schema writes), and improved treatment and case handling logic
• Overhauled authentication system, including migration to session cookies, MFA (SMS) support, improved signup/login flows, and better handling of edge cases like token revocation and limbo users
• Improved invitation and account flows, including UI updates, better error handling, and more reliable verification and password reset behavior
• Continued major improvements to treatment plans and case structure, including better validation, reorganization logic, and support for cases without evaluations
• Enhanced PDPM logic and AI suggestions, including smarter filtering, improved prompts, and safeguards against overwriting existing data
• Improved handling of diagnoses, measures, and service logs, including UI consistency, better suggestions, validation improvements, and workflow refinements
• Added numerous validation and safety checks, including array bounds, date constraints, ICD-10 validation, and prevention of invalid admissions or overlapping records
• Fixed a wide range of UI bugs and edge cases, including navigation issues, crashes, hydration bugs, and form interaction inconsistencies
• Updated dependencies, improved linting and TypeScript strictness, and cleaned up deprecated or unused code
• Improved overall performance, stability, and developer experience

Jan 2026​

• Completed a major overhaul of PDPM assessments, including PT, OT, and SLP case-mix group calculations, GG measures, BIMS scoring, comorbidities, assistive devices, and tighter validation rules
• Added AI- and rule-based PDPM suggestions, improved suggestion UX, clearer icons, better typing, and ensured suggestions properly dirty forms
• Improved admission workflows, including moving PDPM assessments into admissions, enhancing navigation, validating reference dates, and refining clinical category logic
• Significantly expanded and refactored the measures system, including discontinued goals, validation improvements, cleaner utilities, better form layouts, and clearer separation of concerns
• Reworked service logs end-to-end: unified service log models, added Zod validation, enforced co-treatment and concurrent treatment limits, improved progress indicators, and fixed multiple edge cases
• Enhanced case, evaluation, recertification, progress report, treatment, and discharge forms with improved typings, standardized layouts, and better UI consistency
• Restructured treatments to live directly under cases (not certifications), enabling more flexible workflows and support for treatments without evaluations
• Added better handling of locking and date constraints, preventing edits prior to locked dates and invalid measurement timing
• Improved cloud function reliability through extensive refactoring, helper utilities, stricter assertions, and cleaner schema enforcement
• Refined case timelines and document views, including payor details, improved navigation, and clearer sectioning
• Removed deprecated or redundant features, including the AI chatbot and unused measure forms
• Improved time zone handling, date validation messaging, and tooltip coverage across the app
• Fixed numerous UI bugs and edge cases, including drag-and-drop issues, hydration errors, infinite re-renders, sidebar navigation glitches, and broken buttons
• Updated ICD-10 data sources and improved resilience when codes load slowly
• Reduced AI prompt size and complexity while improving suggestion accuracy
• Cleaned up and modernized large portions of the TypeScript codebase, improving maintainability and compile-time safety
• Updated dependencies, build tooling, and internal documentation
• Improved overall performance, stability, and developer ergonomics

Dec 2025​

• Rebranded from Satxuma to RehabAlpha (docs, logos, and color palette)
• Added missing speech-language pathology CPT codes and updated terminology to “speech-language pathologists”
• Improved AI prompts and safeguards, including admissions context and prevention of invalid ICD-10 code suggestions
• Fixed multiple data deletion bugs across treatments, evaluations, coverages, admissions, and user invites
• Implemented full evaluation lifecycle support, including creating, saving without dirty state, deleting, and supporting cases without evaluations
• Added measures to case forms and improved evaluation and case-related UI throughout the app
• Enhanced notices system reliability, including snoozing, cleanup of outdated notices, refresh logic, and migration to scheduled cloud functions
• Improved coverage, billing period, and authorization validation and UI behavior across multiple edge cases
• Allowed contracts to have no end date and clarified required date and time fields in complex scenarios
• Significantly improved UI consistency and usability, especially for timelines, admissions, recerts, progress reports, discharges, and low-resolution screens
• Added scroll spy navigation to more pages and standardized headers and article layouts
• Fixed role- and scheduling-related issues when users change roles within an organization
• Improved security rules, subscription cleanup, and overall state management reliability
• Updated documentation extensively, including admissions, facilities, coverages, authorizations, notices, and progress report timing
• Updated packages and build tooling, including migrating to the new ESLint flat config format
• Fixed numerous smaller bugs, build issues, and visual inconsistencies
• Improved overall performance and stability

Nov 2025​

• Allowed nullable end dates for contracts, billing periods, coverages, and labor logs to support ongoing items (matching admissions behavior)
• Improved date handling in the UI for admissions and coverages
• Improved time zone handling across the app
• Implemented role-based tables for physicians, staff, and others (replacing the single master table)
• Restructured the Payors and Facilities tables
• Moved Delete actions for facilities, payors, people, etc. into a unified “Danger Zone” section in settings
• Expanded user permissions
• Improved the AI suggestions prompt
• Implemented rule-based and AI-based suggestions for clinical documentation
• Prefilled rule-based suggestions for new cases based on patient history
• Ensured proper deletion of subcollections when a facility or patient is deleted
• Removed the isActive property from person and facility documents
• Added suggestions for treatment diagnoses
• Added treatments to the Upcoming table on the user dashboard
• Prevented unlinking a user when they are the last admin in the organization
• Displayed a brief checkmark icon on successful form submissions when no redirect occurs
• Prevented changing a facility’s type while it is linked to active therapy cases
• Incorporated patient age and gender into AI prompts
• Supported multiple suggestions for a single form field
• Fixed miscellaneous bugs
• Improved performance

Oct 2025​

• Implemented permissions form
• Refactored prior hospitalization to no longer reference an admission
• Introduced basic AI suggestions for evaluations, recerts, progress reports, and discharges
• Improved unit test coverage
• Moved Invite and Delete buttons from the header to the settings section
• Updated the Quick Start Guide
• Added preliminary setup for the facility invoice report (not yet implemented)
• Improved the billing period view UI
• Dynamically included GG wheelchair measures based on assistive device usage
• Revised the list of template measures, including GG categorizations
• Refactored measures to support template categories and N/A Categories
• Allowed events to include an end date without requiring an end time
• Locked documents from editing once a signature or signature request is present
• Implemented Create Coverage dialog for adding coverage on the fly
• Added tooltips throughout the interface to clarify field meanings
• Added a checkbox to include or exclude private payors in the coverage form payor selector
• Improved the display and layout of case cards
• Removed title field from treatment documents
• Implemented Fee-for-Service and Tiered Rates contract types
• Fixed miscellaneous bugs

Sep 2025​

• Added reportsTo field to store organizational structure
• Added title field to store employee titles
• Added employmentPeriods field to track employment history for therapists, physicians, and non-clinical staff
• Added contraindications field to evaluations, recerts, and discharges
• Added height and weight fields for patients
• Added customizable N/A Categories to measures to support non-applicable measurements
• Restructured measures into tabs to reduce space usage in evaluations, recerts, etc.
• Improved error handling for measures
• Implemented measure locks to prevent data changes after a document is signed
• Implemented the ability to discontinue a measure (without deleting it)
• Implemented the ability to restore discontinued measures
• Improved measure graphs
• Prevented role changes after assignment
• Standardized UI for forms and views
• Added speech CPT codes 97129 and 97130
• Fixed miscellaneous bugs
• Added PDPM section to billing periods for Medicare Part A payors
• Modified service logs to support minutes (duration) for all codes, including non–time-based codes, to improve productivity tracking
• Implemented tooltips to explain UI elements directly within the interface
• Improved performance

Aug 2025​

• Implemented Coverages
• Added a Data Model guide
• Improved the appearance of admission cards
• Implemented a facility-level timezone selector and propagated it to related records
• Updated combobox text to be more descriptive than “Select values”
• Implemented billing periods within admissions
• Automatically created a private payor and default coverage for all new patients
• Fixed miscellaneous bugs
• Improved performance

July 2025​

• Added documentation and launched a blog (including this one!)
• Added an AI chatbot powered by Google Gemini
• Added a global progress bar that appears during navigation and loading states
• Added notices for expired treatments that do not have a resolution
• Updated the ICD-10 code list to include all codes
• Began implementation of Download PDF functionality for evals, recerts, treatments, etc. (not yet finished)
• Tracked and stored time-based and non–time-based CPT codes differently
• Added support for facility contracts
• Allowed users to mark themselves as available for treatment even outside scheduled hours
• Added tag support to all documents (certifications, progress reports, treatments, and discharges)
• Fixed miscellaneous bugs
• Improved performance

June 2025​

• Released our new promo video
• Added treatments to the schedule page
• Added a resolution field to treatments
• Added a therapist field to treatments, progress reports, evaluations, recertifications, and discharges
• Added documentation-due cards to the case timeline
• Populated the therapist field by default when creating a new treatment
• Added treatment plan descriptions to cases and certifications
• Removed the locality field (now implied by state and county)
• Improved combobox behavior and consistency
• Prevented selecting a therapist without a valid license for the state of the admission
• Added a warning when the selected therapist is not an active user
• Corrected the case timeline sort order
• Improved case timeline colors
• Improved notices throughout the app
• Standardized colors for progress reports, evaluations, treatments, etc. across all pages
• Implemented statistics on the schedule page
• Added avoidTherapists and avoidPatients to planner settings
• Added therapist and patient scheduling settings
• Added autoscheduling settings for treatment documents
• Implemented a “treatments per week” treatment plan option
• Fixed miscellaneous bugs
• Improved performance