Google+ Nancy Beckley Rehab Center Compliance Experts : Nancy Beckley & Associates
Subscribe via RSS Feed Connect on Google Plus Connect on LinkedIn

RACs

RAC Therapy Reviews Underway: 2014 Therapy Claims

RAC Therapy Reviews Underway: 2014 Therapy Claims

RAC therapy reviews are underway as CMS paved the way for manual medical review of therapy claims over the $3700 threshold by the Recovery Auditors (RACs). Effective January 16th CMS provided a contract addendum to the current (outgoing) RACs in all 4 regions to begin a review of therapy claims over $3700 submitted between March […]

February 26, 2015 3 Comments
$3700 Therapy Threshold RAC Reviews

$3700 Therapy Threshold RAC Reviews

$3700 therapy threshold RAC reviews have resumed even though the larger RAC program has been “paused”.  Therapy over the $3700 per beneficiary thresholds ($3700 for PT & SLP combined, another $3700 for OT) is mandatorily reviewed for medical necessity.  CMS has assigned the review task to the RACs.  According to information provided by CMS to the […]

December 4, 2014 1 Comment
RAC Restart Facts…(Not Rumors)..So Far

RAC Restart Facts…(Not Rumors)..So Far

The therapy community is abuzz with all the rumors and misinformation on the RAC restart facts. So far there are a few things that we do know.  We know that CMS wrote letters to members of Congress on Friday August 1st announcing their intention to have a limited restart to the “paused” RAC program. We also know […]

August 12, 2014 2 Comments
CMS to Restart Some RAC Reviews

CMS to Restart Some RAC Reviews

CMS announced today that it is initiating contract modification with the current Recovery Auditors in Regions A, B, C and D to restart reviews of a limited number of issues.  While CMS had previously announced that new Recovery Auditor (RAC) contracts would be announced for Regions 1-5 no later than August 15th their announcement today […]

August 4, 2014 3 Comments

Subscribe to Rehab Compliance Newsletter

Subscribe to Blog Posts

Enter email address below and receive blog posts when they are published.

Privacy guaranteed. We never share your info.

Compliance

Complimentary Compliance Course: Medicare 8 Minute Rule

Complimentary Compliance Course: Medicare 8 Minute Rule

Try it for free: Purchase this course for $0.00, yes it’s absolutely free! I am finishing up 2015 courses for Annual Compliance Training to be posted to my LMS, as well as to PhysicalTherapist.com. I’d love your feedback! Follow the link to Medicare 8 Minute Rule.  

March 22, 2015 2 Comments
Physical Therapy in OIG 2015 Work Plan

Physical Therapy in OIG 2015 Work Plan

Physical therapy in the Office of Inspector General (OIG) 2015 Work Plan should be no surprise.  Physical therapists in private practice have been in the cross hairs in the OIG’s annual Work Plan for the past four years.  The OIG has issued several reports under Office of Audit Services #W-00-11-33220 including Spectrum Rehabilitation, LLC, Claimed Unallowable Medicare […]

November 30, 2014 1 Comment
2015 Therapy Cap Values

2015 Therapy Cap Values

CMS has announced the 2015 Therapy Cap values for 2015 for physical therapy and speech-language pathology combined and occupational therapy.    The therapy caps were initiated under the Balanced Budget Act of 1997 (P.L. 105-33, Section 4541(c)) to implement a per beneficiary annual cap (financial limitation) on the amount of therapy services under Medicare Part B.  The original […]

November 26, 2014 0 Comments
Keep Using 59 Modifier

Keep Using 59 Modifier

 CMS issued MM 8863 on Modifiers for Distinct Procedural Services in August leaving the therapy community wondering how to best use the new subset of the 59 modifier.  The subset, referred to as  X{EPSU}, was established to further define those “distinct  procedural services” identified as: XE – Separate Encounter XS – Separate Structure XP – Separate Practitioner XU […]

November 25, 2014 1 Comment