On July 27, 2022, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2023 final rule for Inpatient Rehabilitation Facilities (IRFs). Highlights of the final rule include: CMS estimates that overall IRF payments for FY 2023 will increase by 3.2% relative to payments in FY 2022 CMS is finalizing a permanent 5% cap on annual wage index decreases to smooth year-to-year changes in providers’ wage index payments CMS is finalizing a policy to expand the IRF quality data reporting requirements, which currently apply to all admitted IRF patients with Medicare Part A fee-for-service (FFS) and Medicare

On July 29, 2022, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2023 Skilled Nursing Facility (SNF) final rule. Highlights of the final rule include the following:

BCBS of Massachusetts will be retiring online services on August 12, 2022. Since BCBS of Massachusetts requires a referral for outpatient rehabilitation and home health care, providers of therapy services must begin using the new system by August 12, 2022. To access this information and be ready for August 12, 2022, click

In this article, I will answer the following questions regarding physicians and nonphysician practitioners certifying and recertifying an outpatient therapy plan of care:

QuestionMust Medicare Advantage plans cover maintenance therapy in the same manner that traditional Medicare covers maintenance therapy? Answer

QuestionDoes the 10th visit Progress Report that applies to traditional Medicare patients also apply to all Medicare Advantage plans and their respective beneficiaries? Answer

QuestionI know traditional Medicare requires a dated signature of the physician or nonphysician practitioner (NPP) whom the Medicare beneficiary is under their care while receiving outpatient physical, occupational and/or speech therapy services. Does this same requirement apply to Medicare Advantage plans whose beneficiaries are receiving outpatient physical, occupational and/or speech therapy services? Answer

Palmetto GBA, Medicare Administrative Contractor (MAC) for the states of Alabama, Georgia and Tennessee has provided an updated list of Targeted Probe & Educate (TPE) reviews that impact outpatient physical and occupational therapy in the private practice setting and facility settings such as rehab agencies, skilled nursing facilities and hospital outpatient therapy departments. In this article, I will answer the following questions: