Home Health

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CMS Special Open Door Forum Summary Manual Medical Review Process for Part B Therapy Claims Effective October 1, 2012  

Effective October 1, 2012, CMS will implement a phased Therapy Cap Exception (TCE) process. The implementation schedule is provided below. During this period, the 2012 therapy cap amounts will be $1880 for occupational therapy services and $1880 for the combined services for physical therapy and speech-language pathology. All requests for therapy services above $3,700 which are provided by a speech language therapist, physical therapist, or physician shall be approved or disapproved in advance. Settings... Read More

Special Open Door Forum: Manual Medical Review of Therapy Claims Tuesday August 7; 2-3:30pm ET Conference Call Only The purpose of this Special Open Door Forum (ODF) is to provide an opportunity for providers to ask questions about the mandated manual medical review of therapy services from October 1-December 31, 2012 that was enacted by the Middle Class Tax Relief and Job Creation Act of 2012.  During this Special Open Door Forum, CMS will discuss the implementation of a process... Read More

CMS has released their 2013 Proposed Rule titled:  Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013, Hospice Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies.  Overall, this proposed rule proposes: Updates the Home Health Prospective Payment System (HH PPS) rates to effectively decrease payments by $20 million; Requirements for the Hospice quality data reporting program; Establish requirements for unannounced,... Read More

Centers for Medicare & Medicaid Services (CMS) recently announced extensions to implementation for the 5010 and ICD-10 initiatives.  These extensions will allow providers a little extra time in preparing their billing operation for compliance. There have been a few extensions for the 5010 standards as it was originally expected to be implemented at the beginning of 2012.  This deadline was then extended to April 1.   The penalty-free phase has now been extended once more through July 1 to accommodate... Read More

Washington, DC:  Medicare Payment Advisory Commission (MedPAC) made several payment recommendations that could affect physical therapists in private practices and those working in skilled nursing facilities (SNF) and for home health agencies (HHA). In its March report, MedPAC calls on Congress to repeal the sustainable growth rate (SGR) and replace it with a 10-year path of statutory fee-schedule updates. This path comprises a freeze in current payment levels for primary care and, for all other... Read More