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 [...]
National Government Services (NGS) has posted the schedule for their first ever virtual Medicare University Convention to be held November 16-20, 2009. Last year this convention was held as a live event in Indianapolis, and citing the significant savings in travel and expense, NGS has announced a reduction in the registration fee from $175 to [...]
There seems to be a bit of panic spreading in the therapy community, that is more of a misunderstanding regarding the standing of private practice therapists providing DME supplies for their patients. There seems to be a particular concern for those providing hand therapy services including splints, and wondering if they have to meet the [...]
Automated reviews of rehab untimed codes are underway by the Recovery Audit Contractors in Region C & Region D. It is entirely possible that rehab providers have received recoupment letters as you read this. Simultaneously within CMS the conversion from fiscal intermediaries and carriers to the Medicare Administrative Contractor format has resulted in the development/conversion [...]
On July 20, 2009, CMS published a proposed rule regarding the Medicare Hospital Outpatient Prospective Payment System (HOPPS) for CY 2010. Among other items, the Proposed Rule addresses “long-standing” physician supervision requirements for hospital outpatient diagnostic and therapeutic services. From 42 CFR 410.27(f) “Services furnished at a provider-based department of a hospital must be furnished [...]
The Region C RAC (Connolly) has posted approved issues for two new states, including the addition of untimed codes for Alabama & Georgia. Connolly originally posted the CMS approved issue of untimed codes for automated reviews for South Carolina, and shortly after added the issue for Florida.