Recovery Audit Program and Therapy Services

May 17, 2019
Rick Gawenda

The Medicare Fee-For-Service Recovery Audit Program was initiated in 2009 to reduce improper Medicare payments to suppliers and providers enrolled in the Medicare program. Since its inception, the program has recouped more than $10 billion for the Medicare program. It should be to no ones surprise that therapy services have contributed to the more than $10 billion recouped.

Current approved topics pertaining to therapy include:

  • 0138-SNF-Consolidated Billing for Therapies
  • 0124-Part B Therapies in a Hospital Setting
  • 0073-Inpatient Rehabilitation Facility Stays: Meeting Requirements to be Considered Reasonable and Necessary

To access the complete list of approved topics, click HERE.

Proposed topics pertaining to therapy include:

  • 4A194-Outpatient Therapy Service during Home Health Episode of Care

To access the complete list of proposed topics, click HERE.

I hope you found this article helpful.

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

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