2015 PQRS Changes

The Centers for Medicare and Medicaid Services (CMS) has finalized their changes to the 2015 PQRS program for physical and occupational therapists in private practice. Besides changes in the number of measures that must be reported, CMS is also implementing the requirement that if a physical or occupational therapist in private practice sees at least…

Medicare Enrollment Guidelines for Ordering/Referring Providers

The Centers for Medicare and Medicaid Services has published a fact sheet titled “Medicare Enrollment Guidelines for Ordering/Referring Providers” that is designed to provide education on the Medicare enrollment requirements for eligible ordering/referring providers. It includes information on the three basic requirements for ordering and referring and who may order and refer for Medicare Part…

Inpatient Rehabilitation Facility Payment Fact Sheet Revised

The “Inpatient Rehabilitation Facility Prospective Payment System” Fact Sheet (ICN 006847) was revised and is now available in downloadable format. This fact sheet is designed to provide education on the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS). It includes the following information: background, elements of the IRF PPS, payment updates, and IRF Quality Reporting…

Coverage of Speech Generating Devices

On February 27, 2014, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) posted a Coverage Reminder outlining the coding requirements for consideration as a “dedicated” speech generating device under the National Coverage Determination (NCD) for Speech Generating Devices (IOM 100-02 §50.1).  The coverage reminder also referenced a requirement for a written coding verification for…

MedPAC Recommends Equal Payment for IRFs and SNFs for 17 Conditions

During their November 7, 2014 meeting, the Medicare Payment Advisory Commission (MedPAC) provided a presentation on site-neutral payments for select conditions (17 conditions) treated in inpatient rehabilitation facilities and skilled nursing facilities. The 17 conditions were a mix or orthopedic, pulmonary, cardiac and infections. These conditions accounted for 10% of IRF cases and spending. A…