Category Archives: Therapy Cap

Wednesday, March 27, 2013

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…
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Sunday, February 24, 2013

CMS Clarifies Manual Medical Review Process for 2013

On February 21, 2013, the Centers for Medicare and Medicaid Services (CMS) clarified the manual medical review process for 2013 and the application of the therapy cap as it applies to critical access hospitals. In 2013, Medicare Administrative Contractors (MACs) will conduct

Thursday, February 14, 2013

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…
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