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04/08/24

FY 2025 IRF Proposed Rule Released

On March 27, 2024, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2025 Inpatient Rehabilitation Facility (IRF) proposed rule. To read a summary of the proposed rule, click HERE. To read the entire proposed rule, click HERE.

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04/08/24

FY 2025 SNF Proposed Rule Released

On March 28, 2024, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2025 Skilled Nursing Facility (SNF) proposed rule. To read a summary of the proposed rule, click HERE. To read the entire proposed rule, click HERE. CMS will accept public comments on the proposed rule until May 28, 2024.

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04/01/24

Acupuncture for Chronic Low Back Pain

Since January 21, 2020, the Centers for Medicare and Medicaid Services (CMS) covers acupuncture for chronic low back pain for up to 12 visits in 90 days. If patients are demonstrating improvement, CMS will cover an additional 8 visits for a total of 20 visits annually. Beginning with dates of service on and after January 1, 2024, CMS will

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03/18/24

Billing for Sensory Integration

In this article, I will answer the following questions regarding billing for sensory integration:

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03/11/24

Updated Medicare Payment Amounts for Outpatient Therapy in 2024

Congress has passed legislation increasing Medicare payment for outpatient physical, occupational, and speech therapy provided in all outpatient therapy settings, except for a critical access hospital. In this article, I will provide my members with the estimated payment amounts beginning March 9, 2024, for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2023 payment rate for each CPT code. For my examples, I used the national payment averages for each CPT code. Based on the location of your clinic/organization, your payment may be higher or lower than the national average. Click HERE

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03/11/24

Congress Increases Medicare Payment for Rest of 2024

Congress has passed the Consolidated Appropriations Act, 2024. This legislation has an impact on payment for outpatient physical, occupational, and speech therapy services. In this article, I will answer the following questions:

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03/04/24

Does Aetna Medicare Advantage Follow Medicare’s “8-Minute Rule”?

A question I am often asked is do all Medicare Advantage (MA) plans follow traditional Medicare’s “8-minute rule”. The answer depends on the MA plan. Regarding Aetna MA and do they follow Medicare’s “8-minute rule”, the answer is

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02/26/24

Aetna Implements Assistant Payment Reduction

Aetna has announced they will implement a payment reduction when outpatient therapy services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant. In this article, I will provide answers to the following questions:

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