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08/14/23

Returned Remote Therapeutic Monitoring Management Claims

The Centers for Medicare and Medicaid Services (CMS) have issued instructions regarding remote therapeutic monitoring (RTM) management services claims that were returned in error between January 1, 2023 – June 30, 2023. In this article, I will answer the following questions:

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08/14/23

Preoperative Evaluations FAQs

In this article, I will answer the following questions regarding preoperative evaluations:

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08/07/23

CMS Proposes Lymphedema Coverage Guidelines and Payments

Due to passage of the Consolidated Appropriations Act, 2023, the Centers for Medicare and Medicaid Services (CMS) will begin to reimburse for lymphedema standard and custom fitted gradient compression garments and other items as determined by the Secretary of Health and Human Services (HHS) beginning January 1, 2024. On June 30, 2023, CMS released the calendar year (CY) 2024 Home Health Prospective Payment System proposed rule. In this proposed rule, CMS proposes the following regarding lymphedema compression treatment items:

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08/02/23

CMS Releases FY 2024 IRF Final Rule

On July 27, 2024, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2024 Inpatient Rehabilitation Facility (IRF) final rule. To access the final rule, click HERE. To access the Fact Sheet on the FY 2024 final rule, click HERE.

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08/02/23

CMS Releases FY 2024 SNF Final Rule

On July 31, 2024, the Centers for Medicare and Medicaid Services released the fiscal year (FY) 2024 Skilled Nursing Facility (SNF) final rule. To access the final rule, click HERE. To access the CMS Fact Sheet on this final rule, click HERE.

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07/31/23

Caregiver Training Services CPT Codes Coming in 2024

Beginning with dates of service on and after January 1, 2024, there will be 3 new CPT codes describing caregiver training services. In this article, I will answer the following questions:

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07/26/23

UnitedHealthcare Updates Outpatient Therapy Medical Policy: August 2023

UnitedHealthcare (UHC) has once again revised their Habilitation and Rehabilitation Therapy (Occupational, Physical and Speech) revised medical policy with an effective date of August 1, 2023. The revised policy impacts all UHC Commercial plans and UHC Oxford. The only revision to this revised policy compared to the July 1, 2023 revision is UHC has

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07/24/23

Medicare Estimated Payments for Outpatient Therapy in 2024

On July 13, 2023, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) proposed rule. This proposed rule does have regulatory and reimbursement implications for outpatient physical, occupational, and speech therapy provided in all outpatient therapy settings. In this article, I will provide my members with the estimated payment amounts for calendar year 2024 for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2023 payment rate for each CPT code. For my examples, I used the national payment averages for each CPT

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