Provision of Care, Treatment, and Services
 Revised | November 24, 2008

Content of the History and Physical  

Q.  What specific data must be included in the history and physical?
 
A.  The standards do not specify the content for the H&P, this is determined by the organization's medical staff.  The data should be pertinent and relevant and should include sufficient information necessary to provide the care and services required to address the patient's conditions and needs and may vary by setting or level of care, treatment, and services. As such, the specific data could be different for populations, or setting of care, treatment or services.