Question – April 5, 2021
If providing maintenance therapy services to a Medicare beneficiary receiving outpatient therapy services, do those visits count towards their annual therapy threshold dollar amount?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – April 5, 2021
This content is for Gold Members only. Please log in above or Register
If providing maintenance therapy services to a Medicare beneficiary receiving outpatient therapy services, do we need to apply the KX modifier to the CPT codes on the claim form if the Medicare beneficiary has exceeded their annual therapy threshold dollar amount?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – December 13, 2020
This content is for Gold Members only. Please log in above or Register
Can a physical therapist assistant (PTA ) or occupational therapy assistant (OTA) provide maintenance therapy services to a Medicare beneficiary receiving outpatient therapy services?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – September 13, 2017
This content is for Gold Members only. Please log in above or Register
Does the Centers for Medicare and Medicaid Services have a web page dedicated to maintenance therapy?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – September 1, 2017
This content is for Gold Members only. Please log in above or Register
Does the Jimmo Settlement Agreement apply to Medicare Advantage plans?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Updated November 12, 2015
This content is for Gold Members only. Please log in above or Register
On the claim form, how will the Medicare Administrative Contractor (MAC) know whether the therapy is rehabilitative in nature or maintenance in nature?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Updated November 12, 2015
This content is for Gold Members only. Please log in above or Register
If providing maintenance therapy services to a Medicare beneficiary receiving outpatient therapy services, do we need to apply the KX modifier to the CPT codes on the claim form if the Medicare beneficiary has exceeded their annual therapy cap?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Updated November 12, 2015
This content is for Gold Members only. Please log in above or Register
If providing maintenance therapy services to a Medicare beneficiary receiving outpatient therapy services, do those visits count towards their annual therapy cap?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Updated November 12, 2015
This content is for Gold Members only. Please log in above or Register
If providing maintenance therapy services to a Medicare beneficiary receiving outpatient therapy services, what CPT codes do I use to bill the Medicare program?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Posted January 25, 2014 and Reviewed November 12, 2015
This content is for Gold Members only. Please log in above or Register
What happens if the Medicare beneficiary does not have anyone to help them at home carry out the maintenance program? Can I continue to see the Medicare beneficiary and bill the Medicare program for the maintenance therapy services?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Posted January 25, 2014 and Reviewed November 12, 2015
This content is for Gold Members only. Please log in above or Register
Can an assistant carry out a maintenance program with the Medicare beneficiary and/or their family/caregiver?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Posted January 25, 2014 and Reviewed November 12, 2015
This content is for Gold Members only. Please log in above or Register
Who can establish and develop a maintenance therapy program?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Posted January 25, 2014 and Reviewed November 12, 2015
This content is for Gold Members only. Please log in above or Register
Is maintenance therapy covered in Comprehensive Outpatient Rehabilitation Facility (CORF) setting?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Posted January 25, 2014 and Reviewed November 12, 2015
This content is for Gold Members only. Please log in above or Register
In the inpatient rehabilitation facility (IRF) setting, must the patient be expected to return to their prior functional status and/or prior home situation?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Posted January 25, 2014 and Reviewed November 12, 2015
This content is for Gold Members only. Please log in above or Register
Is maintenance therapy covered in the inpatient rehabilitation facility (IRF) setting?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Posted January 25, 2014 and Reviewed November 12, 2015
This content is for Gold Members only. Please log in above or Register
What is the difference between rehabilitative therapy and maintenance therapy?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Posted January 25, 2014 and Reviewed November 12, 2015
This content is for Gold Members only. Please log in above or Register
Prior to the settlement of this lawsuit, did CMS have an “Improvement Standard” for outpatient therapy services?
AnswerThis content is for Gold Members only. Please log in above or Register
Question – Updated November 12, 2015
This content is for Gold Members only. Please log in above or Register
Why did the Medicare Advocacy Organization bring a lawsuit against CMS regarding outpatient therapy coverage issues?
AnswerThis content is for Gold Members only. Please log in above or Register
This content is for Gold Members only. Please log in above or Register