The Office of Management and Budget (OMB) has approved the Advance Beneficiary Notice of Noncoverage (ABN) form and instruction for renewal. In this article, I will provide the answers to the following questions:

The public health emergency (PHE) ended at the end of the day on May 11, 2023. What providers want to know is will the Medicare program continue to reimburse for outpatient therapy services delivered via telehealth after the PHE and if yes, in which outpatient settings and for how long? Several updates have occurred since I published an article on this topic back on May 4, 2023. The article has been updated twice since that date due to new information from the Centers for Medicare and Medicaid Services (CMS). Click HERE to read this article that does contain the latest

The Centers for Medicare and Medicaid Services (CMS) is initiating the Review Choice Demonstration (RCD) program for Inpatient Rehabilitation Facilities (IRFs). In this article, I will provide answers to the following questions:

On May 16, 2023, the Centers for Medicare and Medicaid (CMS) issued a decision memo announcing that CMS finds that power seat elevation equipment on Medicare-covered power wheelchairs (PWCs) falls within the benefit category for durable medical equipment (DME). In the decision summary, CMS states that power seat elevation equipment is reasonable and necessary for individuals using complex rehabilitative power-driven wheelchairs when the following conditions are met:

On May 4, 2023, I published an article “Will CMS Pay for Telehealth After May 11, 2023?“. I have now been receiving questions asking if commercial insurance carriers and Medicare Advantage plans will reimburse for outpatient physical, occupational and speech therapy services delivered via telehealth after the public health emergency (PHE) ends at the end of the day on May 11, 2023. In this article, I will answer that question plus provide links to Cigna, UnitedHealthcare and Humana’s telehealth policies. The answer is

Article updated on May 19, 2023! Disclaimer: This article is current as of May 19, 2023 and if CMS and/or Congress makes any changes, an updated article will be published. The public health emergency (PHE) ended at the end of the day on May 11, 2023. What providers of outpatient therapy services want to know is will the Centers for Medicare and Medicaid Services (CMS) reimburse for outpatient therapy services delivered via telehealth after May 11, 2023. In this article, I will provide answers to the following questions:

UnitedHealthcare (UHC) Medicare Advantage has a new reimbursement policy that could have an impact on outpatient therapy claims billed on a 1500-claim form as well as the UB-04 claim form. In this article, I will provide the answers to the following questions:

Institutional outpatient therapy providers are experiencing claims being denied by their Medicare Administrative Contractor (MAC) beginning on and after April 1, 2023 for claims received by the MAC. In this article, I will answer the following questions: