Inpatient Rehabilitation Facility Services – CERT Errors

Wisconsin Physician Services Medicare has noted recent Comprehensive Error Rate Testing (CERT) denials for Inpatient Rehabilitation Facility (IRF) services. In the majority of these cases, the CERT reviewer determined the documentation did not support that the patient participated in an intensive individual rehabilitation program as required by Medicare regulations. There were also instances where the plan of care (POC) did not document the expected amount of therapy time “by discipline” (physical therapy, occupational therapy, speech-language pathology, and orthotics/prosthetics). Click HERE to see some of the review determinations.