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11/10/12

CMS Adds New Place of Service Code for Therapy

The Centers for Medicare and Medicaid Services (CMS) has established a new place of service (POS) code for patients receiving therapy services at their worksite. The new POS code is…

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11/02/12

Noridian Publishes Q&A Document on Manual Medical Record Review Process

The following Question and Answer (Q&A) summary is from the Medicare web-based training workshop titled “Manual Medical Review Threshold ($3700) Process” and ENCORE held September 27 and October 3, 2012. In some cases, the original questions have been edited for clarity, and answers given during the call may have been expanded to provide further detail and multiple questions have been combined. To access the Q&A document, click…

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11/01/12

Final Rule Released for Therapy Services Reimbursed Under the Medicare Physician Fee Schedule

Today, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for services reimbursed under the Medicare Physician Fee Schedule that includes outpatient therapy services. For therapy services, begin reading on page 68958 and continue through page 68978 of the pdf document. The therapy cap dollar amount will be…

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10/29/12

MAC Contract Awards Protest Updates

Protests have been filed against the Jurisdiction E A/B MAC contract, Jurisdiction 6 A/B MAC contract, and Jurisdiction L A/B MAC contract. The protests impact the states of California, Delaware, Hawaii, Illinois, Maryland, Minnesota, Nevada, New Jersey, Pennsylvania, Wisconsin, as well as the District of Columbia.

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10/29/12

Documenting Medical Necessity for Hip & Knee Joint Replacements

The Centers for Medicare & Medicaid Services has published a MedLearn Matters article as an educational guide to improve compliance with documentation requirements for major joint replacement surgery (i.e. knee and hip). To read the article and how physical therapy plays a role in the decision the Medicare contractor will make when deciding to pay or not pay for the procedure, click…

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10/29/12

Novitas Solutions In & TrailBlazer Health Out

Novitas Solutions transitioned as the Part A MAC for non-private practice settings in the states of Colorado, New Mexico, Oklahoma, and Texas on October 29, 2012. Transition news can be found

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10/14/12

OIG Releases 2013 Work Plan

The Office of the Inspector General (OIG) has released their 2013 work plan. To no ones surprise, rehab is on their radar. For IRF, the OIG will look at appropriateness of admission and level of therapy. The OIG work plan will also focus on independent physical therapists in private practice and high utilization of outpatient PT services. To read the work plan, click…

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10/09/12

CMS Awards Contracts

The Centers for Medicare and Medicaid Services (CMS) has awarded contracts for Jurisdictions that will impact that states of California, Hawaii, Illinois, Minnesota, Nevada, and Wisconsin.

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