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Archive for January, 2014

OIG 2014 Work Plan Includes Physical Therapy

January 31, 2014 2 Comments
OIG 2014 Work Plan Includes Physical Therapy

The Office of the Inspector General (OIG) published their 2014 Work Plan today.  The OIG 2014 Work Plan includes physical therapy.  Physical therapists in private practice have once again been identified as part of the work scope. This topic has been ongoing for the past several years so it comes as no surprise that physical therapy […]

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Medicare G Code Confusion

January 30, 2014 8 Comments
Medicare G Code Confusion

Hum along with me, Big Bird, Grover, Cookie Monster, and the cast of Sesame Street in the Alphabet Song.  Are you humming?  A – B – C – D – E – F – G…………. Ok, stop right there!  Which “G” did you mean?  One of 42 functional limitation reporting G codes for PT and […]

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Therapy EMR Selection – Top Five

January 29, 2014 0 Comments
Therapy EMR Selection – Top Five

My husband and I are remodeling our home.  I mean “down to the studs” remodeling in some areas.  There is nothing like having the proper tools to reduce the workload and stress of a laborious task.   We marveled at some of these tools, like the dry wall lift when we were placing new dry wall […]

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Make Therapy PQRS Simple

January 28, 2014 1 Comment
Make Therapy PQRS Simple

Make Therapy PQRS Simple.  Confused?  PQRS reporting must be implemented by private practice therapists to stave off future payment penalties.  Over the years since its inception this quality reporting program on an annual basis has had different quality reporting measures, different bonus structures, varied reporting methods, varied future payment penalties and a whole lot more.  For therapy providers […]

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Selecting A Therapy Contractor

January 27, 2014 0 Comments
Selecting A Therapy Contractor

Selecting a therapy contractor can be a time consuming and arduous process with many considerations, all of which will significantly impact your facility’s finances. Contract language and negotiation is an art in and of itself, and the nuances of what you agree to in a contract can have a significant impact in regard to your building’s […]

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Home Health Outpatient Therapy

January 26, 2014 12 Comments
Home Health Outpatient Therapy

Home health outpatient therapy often conflicts with outpatient therapy financially, leaving providers to wonder how to figure out if a patient is in a home health plan of care.  There is a misperception on the rules of home health therapy and how it affects traditional outpatient therapy.  Let’s take a look at the different aspects […]

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Therapy Caps at Critical Access Hospitals

January 24, 2014 0 Comments
Therapy Caps at Critical Access Hospitals

Therapy caps at critical access hospitals (CAH) are now in full implementation effective 1/14/2014.  Last year the utilization of therapy at CAH was applied toward the cap, but there was no limitation on the amount of medically necessary therapy that could be provided as the KX modifier was added by CMS only to properly register a […]

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Rehabilitative Therapy v. Maintenance Therapy

January 22, 2014 0 Comments
Rehabilitative 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 sections of the Medicare Benefits Policy Manual.  Providers working in home health, skilled facilities and outpatient venues will now have to differentiate rehabilitative therapy v. maintenance […]

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Medicare Limits on Therapy Services

January 21, 2014 0 Comments
Medicare Limits on Therapy Services

CMS just posted the 2014 version of Medicare Limits on Therapy Services advising beneficiaries about the therapy caps in 2014, the Medicare deductible that they must meet and the 80% payment by Medicare, and the 20% beneficiary liability (which is often covered if a beneficiary has a supplemental or secondary policy).  Most therapy providers don’t bother […]

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Medicare Maintenance Therapy

January 20, 2014 4 Comments
Medicare Maintenance Therapy

Medicare Maintenance Series – Maintenance therapy has recently been clarified by CMS as a result of the JIMMO vs. Sebelius class action lawsuit and settlement.  CMS has differentiated maintenance therapy from restorative therapy and indicates in the updated Medicare Benefits Policy Manual sections that there is no expansion of therapy and nursing coverage, but rather a […]

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