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06/17/24

Does Medicare’s 8-Minute Rule Apply to Inpatient Acute Care Therapy Services?

If a Medicare beneficiary is admitted into the hospital and receives therapy services as an inpatient, Medicare’s 8-minute rule does

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06/13/24

CMS Issues Final Rule for SNF Minimum Staffing

On April 22, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for skilled nursing facilities that will impact nurse staffing, RN on-site requirement, strengthening the facility assessment requirement, and permitting regulatory flexibility. The final rule will be implemented over 3 phases. For non-rural facilities, the final rule is phased in over 3 years from the date the final rule was published in the federal register. For rural facilities, the final rule is phased in over 5 years from the date the final rule was published in the federal register. To access the Final Rule Fact

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06/11/24

Does Medicare Recognize Direct Access for Outpatient Therapy?

Lately, I have been receiving questions regarding the Medicare program and does the Centers for Medicare and Medicaid Services (CMS) recognize and pay for direct access for outpatient therapy services. In this article, I will answer the following questions:

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06/03/24

Outpatient Therapy In an Assisted Living Facility

I receive many questions regarding treating Medicare beneficiaries for outpatient physical, occupational and/or speech therapy who reside in an assisted living facility (ALF). In this article, I will answer the following questions:

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05/27/24

Medicare’s 8-Minute Rule: Who Does it Apply To?

The Centers for Medicare and Medicaid Services (CMS) implemented what has become known as the “8-minute rule” on April 1, 2000. We all know this rule applies to traditional Medicare and outpatient therapy, but what about Medicare Advantage, federal insurance carriers, Medicaid, and commercial insurance carriers? In this article, I will answer the following questions:

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05/20/24

Understanding Railroad Medicare Billing

Many therapists, private practices, and facilities do not understand the difference between traditional Medicare and Railroad Medicare and what they must do in order to be reimbursed for outpatient physical, occupational, and speech therapy services. In this article, I will answer the following questions regarding Railroad Medicare Billing:

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05/13/24

MIPS Promoting Interoperability Hardship Exception

Beginning with the 2024 Merit-Based Incentive Payment System (MIPS) Performance Period, physical therapists, occupational therapists, and speech-language pathologists that participate in the MIPS program are no longer automatically exempted from the promoting interoperability category. If you feel that you are unable to report the promoting interoperability category, you may submit a MIPS Promoting Interoperability Category Hardship Exception Application citing one of the reasons below: Since MIPS eligible clinicians must submit collected data for the required measures in each objective for the same 180 continuous days (or more) during the calendar year, you will want to submit your exception application as

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05/13/24

Medicare Progress Reports

I receive many questions regarding traditional Medicare and progress report rules, regulations, and requirements. In this article, I will answer the following questions regarding progress reports for traditional Medicare:

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