Florida Rehab Providers Now Receiving RAC Demand Letters
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...
View ArticleTherapy Cap for 2009 Announced Transmittal R1851 (CR6660)
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...
View ArticleCMS Posts RAC “101″ Informational Video on YouTube
CMS has recently announced a new round of RAC informational sessions for providers. The video features the slide show used in the original fall RAC informational sessions along with commentary by...
View ArticleRehab Values Codes for OP Rehab Part A Providers Eliminated
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...
View ArticleComprehensive Outpatient Rehabilitation Facilities (CORFs)
In a recent RACMonitor.com article on The Curious Case of the CORF the CORF was described as an “orphan” program that had conflicting regulatory advice for providers in recent years. The Conditions...
View ArticleFinal Rule Released – Includes Temporary Certification Programs for EHR
The HHS Office of the National Coordinator for Health Technology released the final rule today that includes provisions for temporary certification of programs for EHR. (This will eventually be...
View ArticleCMS Requires PTs in Private Practice to Revalidate Enrollment..Be Prepared
CMS has issued an updated MLN Article SE1126 with information regarding mandatory enrollment revalidation based upon the previous MLN Article MM7350. The ACA requires enhanced enrollment procedures...
View ArticleNGS Announces Physical Therapy Edits on Frequency and Duration
NGS, one of the largest CMS Medicare Administrative Contractors, has announced that it will implement new edits for physical therapy services billed on the CMS 1500 (of the electronic equivalent). The...
View ArticleExpedited Review When Therapy Services are Discontinued
Faced with $1900 therapy caps, and $3700 manual medical review by Recovery Auditors (RACs) therapy providers are cautious about providing therapy services that may not be deemed medically necessary by...
View ArticleRehabilitative Therapy v. Maintenance Therapy
Medicare has debunked the myth of the “improvement standard and Jimmo v. Sebelius Settlement Agreement has guided CMS in policy updates to the home health, skilled nursing and outpatient therapy...
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CMS Emergency Preparedness Modifications
CMS has proposed modifications to the Emergency Preparedness Condition of Participation designed to lessen the burdens, particularly for small providers in compliance with the detailed Interpretive...
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