On August 4, 2014, the Centers for Medicare and Medicaid Services (CMS) announced that due to the continued delay in awarding new Recovery Auditor contracts, the CMS is initiating contract modifications to the current Recovery Auditor contracts to allow the Recovery Auditors to restart some reviews. Most reviews will be done on an automated basis, but a limited number will be complex reviews of topics selected by CMS. Work continues on the procurement process for the four Part A / Part B Regions and the national DMEPOS/HH&H Region. The CMS remains hopeful that the new round of Recovery Auditor contracts

Noridian Healthcare Solutions, Medicare Administrative Contractor for the states of Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming, has released several updated articles that impact outpatient therapy services. Articles that were updated include: Therapy Evaluations and Assessment Services Medical Necessity of Therapy Services Wound Care & Debridment – Provided by Therapist Therapy Driving Evaluations High Compression Bandage System Cardiac Rehabilitation Programs for Chronic Heart Failure To access the updated articles, click

National Government Services (NGS) will be providing several webinars for suppliers and providers in Jurisdiction K. This includes the following states: CT, MA ME, NH, NY, RI, and VT. Upcoming webinars include: Part B Providers: The Appeals Process – How to Avoid Appeals on July 30, 2014 Outpatient Physical Therapy/Occupational Therapy LCD/SIA and Changes for 2014 on August 18, 2014 Outpatient Physical Therapy/Occupational Therapy LCD/SIA and Changes for 2014 on September 23, 2014    

The CERT A/B MAC Outreach & Education Task Force, a partnership of all A/B Medicare Administrative Contractors, has created a guide to educate providers on common documentation errors for outpatient rehabilitation therapy services. These widespread errors contribute to Medicare’s national payment error rate, as measured by the Comprehensive Error Rate Testing (CERT) program. The guide also discusses contents for a plan of care, signature and certification of the plan of care, treatment note, and functional reporting requirements. The leading cause of payment errors for therapy services is

Wisconsin Physician Services  (WPS) will hold a three-hour seminar on the Medicare Outpatient Therapy Benefit on August 20, 2014 in Traverse City, MI. The seminar is designed for those who provide or bill physical therapy, occupational therapy, or speech language pathology to Medicare beneficiaries. For additional information and to register, click HERE. In addition, WPS will host an outpatient therapy seminar for skilled nursing facilities on September 10, 2014 in Fort Wayne, IN. The seminar will focus on CCI edits and the proper use of modifier 59, proper coding required when reporting G-codes on the claim form and much more.

The Centers for Medicare and Medicaid Services (CMS) has issued an educational resource detailing signature requirements for physicians, non-physician practitioners, providers, suppliers, and other health care professionals who order or provide Medicare-covered services to Medicare beneficiaries. The Medicare program accepts the following types of signatures: handwritten, electronic, and under certain circumstances, rubber stamped signatures are acceptable. For the complete details on signature requirements for diagnostic tests, DME supplies, Certificates of Medical Necessity, signature guidelines for medical review purposes, and use of rubber stamp for signature, click

The Centers for Medicare and Medicaid Services has released the calendar year (CY) 2015 proposed rule for services reimbursed under the Medicare Physician Fee Schedule that does include outpatient therapy services. Highlights of the proposed rule as they pertain to outpatient rehabilitation therapy are as follows:    

Effective July 1, 2014, physical therapists, occupational therapists, and speech-language pathologists in private practice will begin receiving updated Remittance Advice Remark Codes (RARCs) on their explanation of benefits (EOB’s) for PQRS claims-based reporting that went into effect on April 1, 2014. The new RARCs are as follows: