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12/26/18

Inpatient Rehabilitation Facility Medical Record Review Changes

On December 20, 2018, the Centers for Medicare and Medicaid Services (CMS) revised MLN Matters Number SE 17036 to remove the Admission order requirement from the portion of the article under “Required documentation elements for an IRF claim include, but are not limited to.” To access this ML Matters revision, click HERE. In addition, CMS did clarify the use of students treating Medicare beneficiaries in the inpatient rehab setting. For the latest information on this topic, click HERE.

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12/26/18

CMS Clarifies Student Minutes in the IRF Setting

During a November 15, 2018 Inpatient Rehabilitation Facility (IRF) phone call, a Centers for Medicare and Medicaid Services (CMS) representative stated that according to hospital conditions of participation that Inpatient Rehabilitation Facilities (IRFs) must meet, students do not have a role in providing therapy or therapy minutes to patients, even under direct supervision of the licensed therapist. On December 11, 2018, the American Physical Therapy Association (APTA), American Occupational Therapy Association, and American Speech-Language-Hearing Association participated in a meeting with CMS. During the meeting, CMS indicated that there had been

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12/22/18

TRICARE and Assistants

The Department of Defense has released the long awaited proposed rule where the Department of Defense would add physical therapist assistants (PTA’s) and occupational therapy assistants (OTA’s) as TRICARE authorized providers. In summary, this proposed rule would add PTA’s and OTA’s as authorized TRICARE providers under the supervision of a TRICARE-authorized physical therapist or occupational therapist in accordance with Medicare’s rules for supervision and qualification when billed by under the supervising therapist’s national provider identification number. Regarding supervision requirements, TRICARE is proposing the same supervision requirements for PTA’s and OTA’s

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12/21/18

Is Functional Limitation Reporting Ending

Is functional limitation reporting ending at the end of 2018? The answer depends on what insurance carrier you are asking about. For traditional Medicare Part B beneficiaries, functional limitation reporting (FLR)

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12/19/18

MIPS Questions and Answers: Part 4

Question How does CMS calculates the penalty for those choosing not to participate/report? Answer Question Regarding the Improvement Activities, how can we determine which Improvement Activities are considered high-weighted and which are considered medium-weighted? Answer Question How do we go about opting in and when is the deadline? Answer Question If we have 11 therapists and 7 physicians but all therapy billing is incident to the physician, are we classified as a small practice since we only have 7 physicians? Answer Question If we are excluded from MIPS, do not want to opt-in to MIPS and we submit via claims, is

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12/16/18

MIPS Questions and Answers: Part 3

The Merit-Based Incentive Payment System (MIPS) in 2019 will now include physical therapists, occupational therapists and speech-language pathologists that treat Medicare beneficiaries in the private practice setting. The simplest way to know if you are a private practice under the Medicare program is that you submit claims to your Medicare Administrative Contractor on a 1500-claim form. Over the next several weeks, I will be answering question I receive on the MIPS program to help you get prepared. In addition, I will be presenting a 2.5 hour MIPS webinar tomorrow, December 18, 2018 from 1:00pm – 3:30pm ET. For additional information

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12/10/18

MIPS Questions and Answers: Part 2

The Merit-Based Incentive Payment System (MIPS) in 2019 will now include physical therapists, occupational therapists and speech-language pathologists that treat Medicare beneficiaries in the private practice setting. The simplest way to know if you are a private practice under the Medicare program is that you submit claims to your Medicare Administrative Contractor on a 1500-claim form. Over the next several weeks, I will be answering question I receive on the MIPS program to help you get prepared. In addition, I will be presenting a 2.5 hour MIPS webinar on December 18, 2018 from 1:00pm – 3:30pm ET. For additional information

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12/03/18

MIPS Questions and Answers: Part 1

The Merit-Based Incentive Payment System (MIPS) in 2019 will now include physical therapists, occupational therapists and speech-language pathologists that treat Medicare beneficiaries in the private practice setting. The simplest way to know if you are a private practice under the Medicare program is that you submit claims to your Medicare Administrative Contractor on a 1500-claim form. Over the next several weeks, I will be answering question I receive on the MIPS program to help you get prepared. In addition, I will be presenting a 2.5 hour MIPS webinar on December 18, 2018 from 1:00pm – 3:30pm ET. For additional information

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