Reason’s to Use an ABN for Outpatient Therapy Services: Part 1

In last week’s newsletter, I provided the answers to the following 3 questions regarding routine ABN’s:

1. Can we have all of our Medicare patient’s sign an advance beneficiary notice (ABN) on their initial appointment to protect us in case our Medicare Administrative Contractor (MAC) denies any of our services as not medically necessary?
2. Once a Medicare beneficiary reaches the annual therapy cap dollar threshold ($1940 for physical therapy and speech therapy combined and a separate $1940 for occupational therapy in calendar year 2015), can I have the Medicare beneficiary sign an ABN even though I feel the therapy services are medically necessary to protect us in the event my Medicare contractor denies the services as not medically necessary?
3. Once a patient exceeds $3700 in covered PT and SLP services combined or a separate $3700 in covered OT services in a calendar year, can I have the Medicare beneficiary sign an ABN even though I feel the therapy services are medically necessary to protect us in the event my Medicare contractor denies the services as not medically necessary?

To see the answer’s to the above 3 questions, click HERE.

In this week’s newsletter, I am going to provide one of the main reasons when a provider would need to issue an ABN to a Medicare beneficiary receiving outpatient therapy services. In next weeks newsletter, I will provide additional reasons when an ABN would need to be issued to a Medicare beneficiary receiving outpatient therapy services.

One of the main reasons an ABN would need to be issued to a Medicare beneficiary receiving outpatient therapy services is if the Medicare beneficiary is also