On April 15, 2021, Xavier Becerra, Secretary of Health and Human Services, renewed the Public Health Emergency (PHE) due to COVID-19. The PHE will now end at the end of the day on July 19, 2021. Due to this extension, the Centers for Medicare and Medicaid Services (CMS) will continue to reimburse for outpatient physical, occupational and speech therapy services delivered via telehealth until at least until the end of the day on July 19, 2021.

On March 1, 2021, I published an article titled “Supervision Requirements of Therapy Students Under the Medicare Program“. This article specifically addressed traditional Medicare. Of course, that article then led to questions regarding the supervision requirements of therapy students treating Medicare Advantage patients and do the traditional Medicare supervision requirements apply to Medicare Advantage plans. In this article, I will answer that question. QuestionDo the traditional Medicare supervision requirements of therapy students also apply to Medicare Advantage plans and their respective beneficiaries? Answer I hope this answer has helped you. Thank you for being a Gold Member!

Effective with dates of service on or after 9/1/2020, the Outpatient Hospital Correct Coding Initiative (CCI) Editing policy will apply to all network and non-network hospitals. In addition, the policy will apply to all outpatient types of bills that are applicable to these edits. Click HERE to read the announcement straight from UnitedHealthcare.

On April 13, 2021, the United States House of Representatives passed H.R. 1868 which extends the pause on the 2% sequestration reduction through the end of calendar year 2021. This legislation was passed by the United States on March 25, 2021. President Biden signed this legislation into law on April 14, 2021.

Ever since the Centers for Medicare and Medicaid Services (CMS) implemented the Targeted Medical Review process, providers of outpatient therapy services have referred to this as the “second cap”, the “second tier”, or the “second threshold” with the “first cap” or “first tier” being the annual therapy threshold (formerly called the therapy cap). In this article, I will answer common questions I receive on the annual therapy threshold and the targeted medical review and provide criteria on how claims may be selected for a targeted medical review. QuestionWhat is annual therapy threshold dollar amount for calendar year 2021? Answer QuestionIn

On April 8, 2021, the Centers for Medicare and Medicaid Services (CMS) issued the fiscal year (FY) 2022 Skilled Nursing Facility (SNF) proposed rule. Comments will be accepted on the proposed rule until 5:00pm on June 7, 2021. The proposed rule is schedule to be published in the Federal Register on April 15, 2021. Highlights of the proposed rule include the following: CMS is proposing to update the SNF payment rates by 1.3% CMS is soliciting broad public comments on a potential methodology for recalibrating the PDPM parity adjustment that would account for the potential effects of the COVID-19 PHE

On April 7, 2021, the Centers for Medicare and Medicaid Services released the fiscal year (FY) 2022 Inpatient Rehabilitation Facility (IRF) proposed rule. Comments will be accepted on the proposed rule until 5:00pm on June 7, 2021. The proposed rule is schedule to be published in the Federal Register on April 12, 2021. Highlights of the proposed rule include the following: CMS is proposing to update the IRF PPS payment rates by 2.2% For the Quality Reporting Program, CMS is proposing to add 1 measure and update the specifications for another measure CMS is proposing the adoption of the COVID-19 Vaccination Coverage among

The Centers for Medicare and Medicaid Services (CMS) has updated the list of outpatient physical, occupational and speech therapy services that can be delivered via telehealth during the COVID public health emergency (PHE). The additional CPT codes added are as follows: 92526 92607 92608 92609 92610 92626 92627 96105 96125 97129 97130 To view the entire list of CPT codes that can be delivered via telehealth and reimbursed by CMS, click HERE. Remember that once the PHE is declared over, physical therapists, occupational therapists and speech-language pathologists will no longer be able to be reimbursed by the Medicare program for