During a Centers for Medicare and Medicaid Services (CMS) “Office Hours” call on May 21, 2020, CMS did confirm the following regarding hospital outpatient therapy departments providing outpatient therapy services remotely to a Medicare Part B beneficiary in their home while the therapist or assistant is physically in the hospital: I hope you found this article helpful. In addition, I would also recommend you read “Can Hospital Therapy Departments Provide Telehealth Services“. Thank you for being a Gold Member!

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The Centers for Medicare and Medicaid Services (CMS) is proposing to change the way it reimburses hospitals for facility fees for  emergency department visits. CMS officials want to replace five escalating price codes hospitals can choose from in billing facility fees with one flat rate, starting next year. The 2013 rates for ED facility fees start at $51.82 for a Level 1 patient visit and move up to $344.71 at the top range. For 2014, the CMS is proposing a new flat rate of $212.90 for ED visits, regardless of how intensive the treatment is. To read the full story

First Coast Service Options, Inc., a Medicare Administrative Contractor, has put together a nice slide presentation on appropriate physician signatures in the medical records. This would also be applicable for therapists and assistants. Even though this was done by First Coast, the requirements are CMS requirements, hence, this presentation would be applicable for all providers in all states.

On May 2, 2013, Indiana Governor Mike Pence signed HB 1034 into law. HB 1034 provides Indiana residents direct access to evaluation and treatment by a physical therapist (PT) without a physician referral. The law, which will take effect on July 1, allows for evaluation and up to 24 days of treatment without a referral but continues to require a referral for spinal manipulation and sharp debridement. For additional information, visit the APTA website.

From the Wall Street Journal, a state-by-state comparison on healthcare costs for calendar year 2009. Click HERE for the story.

The Medicare Payment Advisory Commission (MedPAC) renewed its calls to reform the Medicare physician payment system in its annual report to Congress on Medicare payment policy issued March 15 and in congressional testimony given the same day. To read the report, click HERE.  

For dates of service January 1, 2013 through December 31, 2013, all outpatient therapy claims submitted above the $3,700 threshold will be subject to prepayment medical review. CGS will send Additional Documentation Requests (ADRs) for all claims above the $3,700 threshold. In these ADRs, CGS will request the following documentation: