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 issued CR6899 indicating that effective 10-1-2010 outpatient rehab providers will no longer have to report value codes for the number of visits (Code 50 for PT, Code 51 for OT, Code 52 for SLP and Code 53 for Cardiac). This change affects Part A outpatient therapy providers (billing on CMS 1450/UB04) including CORFs, [...]
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 [...]
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 [...]