Outpatient Therapy Common CERT Errors

May 27, 2019
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Rick Gawenda
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The Centers for Medicare and Medicaid Services (CMS) has released a new booklet where they describe common outpatient rehabilitation therapy services Comprehensive Error Rate Testing (CERT) Program errors, how the CMS calculates improper payment rates, the necessary documentation to support billed Medicare claims, and managing potential overpayments. Some of the more common CERT errors include:

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  1. Can you clarify ……does a PT need to document start and stop time for an EVAL or can they just document the total tx time of the EVAL? I would think its total Eval time (not needing start and stop). If tx is done in EVAL visit, does that change the scenerio? My understanding is if you did a total of 1:1 Manual for 8 min (maybe interspersed in the EVAL visit you bill for that total time too. J

    1. The Medicare program requires total timed minutes and total treatment time be documented for each visit.