Category Archives: Current News

Thursday, February 15, 2018

Updated Editing of Always Therapy Services

The Centers for Medicare and Medicaid Services released MedLearn (MLN) Matters 10176 on December 21, 2017 and is related to Change Request (CR) 10176. CR 10176 implements revised editing of Part B “Always Therapy” services to require the appropriate therapy modifier in order for the service to be accurately applied to the therapy cap. CR…
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Sunday, February 11, 2018

Therapy Cap Repealed – Implications for Providers

On February 9, 2018, the United States Senate and House of Representatives passed H.R. 1892 – “Bipartisan Budget Act of 2018” and President Trump signed the bill into law at approximately 8:30am ET on February 9, 2018. The bill passed the Senate by a vote of 71-28 and passed the House of Representatives by a…
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Sunday, February 11, 2018

Targeted Medical Review Changes for Outpatient Therapy Services

On February 9, 2018, the United States Senate and House of Representatives passed H.R. 1892 – “Bipartisan Budget Act of 2018” and President Trump signed the bill into law at approximately 8:30am ET on February 9, 2018. The bill passed the Senate by a vote of 71-28 and passed the House of Representatives by a…
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Sunday, February 11, 2018

Payment for Services Provided by Assistants to be Reduced

On February 9, 2018, the United States Senate and House of Representatives passed H.R. 1892 – “Bipartisan Budget Act of 2018” and President Trump signed the bill into law at approximately 8:30am ET on February 9, 2018. The bill passed the Senate by a vote of 71-28 and passed the House of Representatives by a…
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Friday, February 9, 2018

Congress Repeals Medicare Therapy Cap

In the early morning hours of February 9, 2018, the United States Senate and House of Representatives both passed legislation that repeals the outpatient therapy cap; however, changes payment rates for services provided by a physical therapist assistant and/or occupational therapy assistant to Medicare beneficiaries receiving outpatient therapy services. In addition, the legislation also makes…
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Thursday, February 8, 2018

Medicare Program to Pay for TKAs On An Outpatient Basis

The Centers for Medicare and Medicaid Services, on November 1, 2017, finalized their proposed rule to remove total knee arthroplasty (TKA) from the inpatient procedure only (IPO) list and allow Medicare beneficiaries to have their knee replaced on an outpatient basis beginning with dates of service on and after January 1, 2018. This procedure will…
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Monday, February 5, 2018

2018 Therapy Cap as of February 5, 2018

The House of Representatives and the Senate have failed to act to pass legislation to either repeal the outpatient therapy cap or to extend the therapy cap exception process for Medicare beneficiaries receiving outpatient physical and/or occupational therapy as well as speech-language pathology services in calendar year 2018. So what does this mean for providers…
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Monday, February 5, 2018

SLPs Billing CPT Codes 97110, 97112 & 97530

A question I receive is can speech-language pathologists (SLP’s) bill CPT codes 97110 (therapeutic exercise), 97112 (neuromuscular reeducation) and 97530 (therapeutic activities) instead of CPT codes 92507 (treatment of speech, language, voice, communication, and/or auditory processing; individual), 92508 (treatment of speech, language, voice, communication, and/or auditory processing; group) and/or 92526 (treatment of swallowing dysfunction and/or…
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