In memory of Randy Snow, Wheelchair Athlete, Paralympian, and Olympic Hall of Fame member.  I am saddened to learn of Randy’s death on November 19th while he was in El Salvador hosting a clinic.  I first met Randy in 1984 when I invited him to participate in the inaugaural run of the Wheelchair Division of [...]

CMS has announced the therapy cap for 2010 is $1860, representing a $20 increase over the 2009 therapy cap.  Transmittal R1851 to the Medicare Claims Processing Manual, dated 11/13/2009 and the accompanying MLN Article MM6660 provide information on the implementation.  The Balanced Budget Act of 1997 (BBA) established a $1500 therapy cap for physical therapy (including speech-language [...]

Florida therapy providers are beginning to report the receipt of official “demand letters” from Connolly Healthcare, the Region C Recovery Audit Contractor.   A Florida therapy provider, who asked not to be identified, has reported receiving several demand letters related to the billing of speech therapy untimed codes in units greater than one.  This provider has multiple [...]

Trailblazer , the MAC J4 contractor has released a DRAFT Physical Medicine & Rehabilitation Outpatient LCD (local coverage determination).   The draft LCD is posted as of October 30, 2009 for a 45 day comment period that ends December 14, 2009.  According to Trailblazer: This LCD establishes frequency limitations of 5 (15-minute) PT or OT services per [...]