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02/15/13

WPS “Appealing a Medicare Denial” Teleconference

Wisconsin Physician Services (WPS) will be hosting several webinars in March 2013 titled “Appealing a Medicare Claim Determination” for providers in the states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin. Click

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02/15/13

Noridian Updates Phone Number

Noridian Administrative Services, Medicare Administrative Contractor for the states of Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming, has updated its current customer service phone numbers to a single phone number that will serve all the above mentioned states. The new number is

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02/15/13

Noridians’ Outpatient Therapy Resources

Noridian Administrative Services (NAS), Medicare Administrative Contractor for the states of Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming, has a webpage dedicated to outpatient therapy that offers many resources to private practices and non-private practices. To access the information, click

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02/14/13

Novitas Solutions Outpatient Therapy Teleconference

Novitas Solutions, Medicare Administrative Contractor for the states of Arkansas, Colorado, Delaware, Louisiana, Maryland, Mississippi, New Jersey, New Mexico, Oklahoma, Pennsylvania, Texas, and Washington DC, held a teleconference on Physical and Occupational therapy billing for private practices on January 28, 2013 and for non-private practices on January 31, 2013. Novitas Solutions has published the handout on their website for providers to view. To access the handout

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02/14/13

Skilled Maintenance Services Covered by Medicare

From The Center for Medicare Advocacy, Inc. The Center for Medicare Advocacy, along with its co-counsel Vermont Legal Aid are pleased that the Settlement in the Medicare Improvement Standard case, Jimmo v. Sebelius,was approved on January 24, 2013 during a scheduled fairness hearing, marking a critical step forward for thousands of beneficiaries nationwide. The proposed settlement agreement was filed in federal District Court on October 16, 2012. The plaintiffs joined with the named defendant, Secretary of Health and Human Services Kathleen Sebelius, in asking the federal judge to approve the settlement of the case. With only one written comment received,

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02/14/13

Functional Reporting

The Centers for Medicare and Medicaid Services will require providers to report patient functional status at certain intervals during their episode of treatment. This began on January 1, 2013 on a voluntary basis and will be mandated to be reported on claim forms and in the therapists documentation beginning on July 1, 2013 for all traditional Medicare patients. Plan on attending my webinar titled “2013 Medicare G Codes: Mandated Reporting of Patient Functional Status” to be held on April 24, 2013 from 1:00PM – 2:00PM EDT. For additional information and to register, click HERE.

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02/14/13

CAH Not Under Caps

The Centers for Medicare and Medicaid Services has informed the American Physical Therapy Association and the American Hospital Association that critical access hospitals (CAHs) will not be under the therapy cap. However, therapy furnished in the outpatient department of a CAH will be applied to the therapy cap dollar threshold for all other outpatient therapy settings.

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01/25/13

UnitedHealthcare Medicare Solutions

Effective Jan. 1, 2011, the Centers for Medicare and Medicaid Services (CMS) initiated a new multiple procedure payment reduction policy to reduce the practice expense portion of certain physical, occupational and speech/language therapy procedures by 20 percent in the priavte practice setting, when these procedures are the secondary and/or subsequent procedures reported on a single date of service for the same patient. The policy applies to procedures identified with a Multiple Procedure (MP) indicator 5 on the CMS National Physician Fee Schedule. UnitedHealthcare Medicare Solutions will align with CMS and implement the new Multiple Therapy Reduction Policy, effective with claims

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