Hospitals

June 18, 2013 -  CMS has provided the following update based on the June 4th Open Door Forum statement that "on July 1st funcational reporting will start which requests doing initial evals, goals & status.  The July 1st treatment has to be treated as the initial eval, even if [provider] have been treating the patient.  [CMS] realizes it is 'a little bit of a burden' but feel it is necessary."   CMS had previously indicated that therapists must report functional information on the first... Read More

Click here for the recently posted HIPAA Modifications.

CMS Announces Educational Call for Providers on Functional Testing Requirement  

December 12, 2012 1:30 - 3:00pm EST

The transcript and audio file for the October 22, 2012 Manual Medical Review of Therapy Claims Special Open Door Forum is available on the Special Open Door Forum web page: http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODFSpecialODF.html . Thank you for your continued interest in the CMS Open Door Forums. http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODFSpecialODF.html Read More

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

Centers for Medicare & Medicaid Services Special Open Door Forum: Manual Medical Review of Therapy Claims   Wednesday, September 5, 2012 2:00pm – 3:30pm Eastern Time Conference Call Only 

8.22.2012

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 Physician Fee Schedule Proposed Rule for CY 2013 Impact to Rehabilitation Providers: Claims based data collection based on the provision of the Middle Class Tax Relief and Jobs Creation Act (MCTRCA).  This would be for informational purposes only and not impact reimbursement of the submitted claim.  CMS would add codes and modifiers which would have to be appended to submitted claims by the provider.  The effective date would be 1/1/2013; however, there would be a grace/testing... Read More