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12/28/12

CMS Revises Several Transmittals Related to Therapy

On December 21, the Centers for Medicare & Medicaid Services revised several transmittals related to the claims-based data collection requirements for outpatient therapy. To access the transmittals, click on the appropriate link below.

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12/03/12

CMS Releases Several New Transmittals Related to Therapy

On November 30, 2013, The Centers for Medicare and Medicaid Services released 4 transmittals that have implications for outpatient therapy. Two of the transmittals deal with the implementation of the claims-based data collection requirements for outpatient therapy and contain the same information, one deals with the therapy cap dollar amount for 2013, and the fourth deals with a new place of service (POS) code for place of employment/worksite. The new POS code is…

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11/27/12

Noridian Publishes Several Therapy News Updates

Noridian Administrative Services, Medicare contractor for the states of Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming, has released several publications on November 19 and 20, 2012 related to outpatient therapy services in the areas of students and aides, use of modifier 59, TENS clarification, billing of time-based codes, therapy services and medical necessity, therapy evaluation and assessment services, biofeedback training, pulmonary rehabilitation, and lymphedema decongestive treatment. Click on each link below to access the respective article.

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11/16/12

CMS Releases 2013 Deductibles

The Centers for Medicare & Medicaid Services (CMS) has released the deductibles for Medicare Part A and Part B for 2013. Medicare Part A pays for inpatient hospital, skilled nursing facility, hospice and home health care services. The 2013 monthly premium will be…

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11/15/12

OIG Finds 1 in 4 SNF Claims Billed Incorrectly

The Office of the Inspector General (OIG) released a report on November 9, 2012 that reveals SNFs billed one-quarter of all claims in error in 2009, resulting in $1.5 billion in inappropriate Medicare payments. The majority of the claims in error were upcoded; many of these claims were for ultrahigh therapy. The remaining claims in error were downcoded or did not meet Medicare coverage requirements. To read the full report from the OIG, click…

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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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