The Medicare Payment Advisory Commission (MedPAC) relased their June report to Congress last week. Of note to the rehab and therapy community is Chapter Eight: “Addressing the Growth of Ancillary Services in Physician Offices.” The chapter on ancillary services addresses outpatient therapy including physical, occupational and speech therapies. Of note is the discussion regarding the growth [...]
Lewis Morris, the Chief Counsel to the Office of the Inspector General (OIG) of HHS provided testimony this morning before the subcommittes on Health & Oversight of the U.S. House Ways and Means Committee. The text of Mr. Morris’s message provides insight into successful fraud and abuse intitatives by the OIG as well as the success [...]
CMS has updated the “Rehabilitation Therapy Information” Fact Sheet and it is now available for downloading at the CMS website. The 4 page flyer inlcudes highlights over therapy changes over the past year including the therapy cap, DME Instructions, SLP in Private Practice, and Therapy Personnel Requirements. There are also links to rehab related Medicare [...]
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 [...]
CGI, the Region B Recovery Audit Contractor has added several new CMS approved issues. The issue of untimed codes for therapy is now approved for Illinois, Indiana, Kentuckhy, Michigan, Minnesota, Ohio and Wisconsin. The issue was approved on 9/30/2009 and covers services from 10/1/2007 forward. According to CGI: Untimed Codes – CPT codes (excluding modifiers KX, [...]