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Archive for November, 2014

Physical Therapy in OIG 2015 Work Plan

November 30, 2014 1 Comment
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 […]

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2015 Therapy Cap Values

November 26, 2014 1 Comment
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 […]

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Keep Using 59 Modifier

November 25, 2014 1 Comment
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 […]

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