Outpatient Therapy Common CERT Errors

May 27, 2019
Rick Gawenda

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:

The content here is for members only log in here or sign up.


All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.

This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

  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.