CMS Provides Further Clarification On The Manual Medical Review Process for 2013

On March 21, 2013, the Centers for Medicare and Medicaid Services (CMS) released additional guidance on manual medical review for outpatient therapy services exceeding $3,700 in calendar year 2013. This applies to all Part B outpatient therapy settings except critical access hospitals. Medicare Administrative Contractors (MACs) will conduct prepayment review on claims reaching the $3,700…

CAH Not Under Caps

The Centers for Medicare and Medicaid Services has informed the American Physical Therapy Association and the American Hospital Association that critical access hospitals (CAHs) will not be under the therapy cap. However, therapy furnished in the outpatient department of a CAH will be applied to the therapy cap dollar threshold for all other outpatient therapy…