Palmetto Updates Therapy Policies
Palmetto GBA, the Medicare Administrative Contractor for the states of Alabama, Georgia, North Carolina, South Carolina, Tennessee, Virginia and West Virginia, has updated their physical therapy, occupational therapy and speech therapy local coverage determinations (LCDs) for nonprivate practices in the above mentioned states. To access the revised LCDs, click HERE.
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We are seeing denials on Therapy eval billing since the change over to Palmetto with reason code being patient previously seen in last three years.
I assume you are speaking about either the PT or OT evaluation CPT codes. If yes, then you need to contact Palmetto as that is an error on their end. You may also want to contact APTA and AOTA.