Google+ CORFs Archives - Nancy Beckley & Associates : Nancy Beckley & Associates
Subscribe via RSS Feed Connect on Google Plus Connect on LinkedIn

CORFs

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 […]

Continue Reading »

Expedited Review When Therapy Services are Discontinued

July 5, 2013 1 Comment
Expedited Review When Therapy Services are Discontinued

Faced with $1900 therapy caps, and $3700 manual medical review by Recovery Auditors (RACs) therapy providers are cautious about providing therapy services that may not be deemed medically necessary by Medicare contractors.  In light of the change in liability for therapy over the $1900 cap in 2013, therapy providers have a choice of obtaining a […]

Continue Reading »

NGS Announces Physical Therapy Edits on Frequency and Duration

September 16, 2011 0 Comments
NGS Announces Physical Therapy Edits on Frequency and Duration

NGS, one of the largest CMS Medicare Administrative Contractors, has announced that it will implement new edits for physical therapy services billed on the CMS 1500 (of the electronic equivalent).  The new edits are effective September 20, 2011 and will screen for frequency and duration of therapy services not consistent with medical necessity.  Per the […]

Continue Reading »

CMS Requires PTs in Private Practice to Revalidate Enrollment..Be Prepared

August 12, 2011 0 Comments
CMS Requires PTs in Private Practice to Revalidate Enrollment..Be Prepared

CMS has issued an updated MLN Article SE1126 with information regarding mandatory enrollment revalidation based upon the previous MLN Article MM7350.  The ACA requires enhanced enrollment procedures effective March 25th of this year based upon identified categorical risk to the Medicare program.  Physical Therapists in Private Practice were elevated to the “moderate risk category” and […]

Continue Reading »

Final Rule Released – Includes Temporary Certification Programs for EHR

June 18, 2010 0 Comments
Final Rule Released – Includes Temporary Certification Programs for EHR

The HHS Office of the National Coordinator for Health Technology released the final rule today that includes provisions for temporary certification of programs for EHR.  (This will eventually be replaced by a permanent certification program).  The entire press release can be found at the HHS website.  “By purchasing certified EHR technology, hospitals and eligible professionals […]

Continue Reading »

Comprehensive Outpatient Rehabilitation Facilities (CORFs)

May 20, 2010 2 Comments
Comprehensive Outpatient Rehabilitation Facilities (CORFs)

In a recent RACMonitor.com article on The Curious Case of the CORF   the CORF was described as an “orphan” program that had conflicting regulatory advice for providers in recent years.  The Conditions of Participation, the State Operations Manual Interpretive Guidelines, and various instructions from the Medicare Contractors (fiscal intermediaries and MACs) put the provider at […]

Continue Reading »

Rehab Values Codes for OP Rehab Part A Providers Eliminated

May 5, 2010 0 Comments
Rehab Values Codes for OP Rehab Part A Providers Eliminated

CMS has issued CR6899  indicating that effective 10-1-2010 outpatient rehab providers will no longer have to report value codes for the number of visits (Code 50 for PT, Code 51 for OT, Code 52 for SLP and Code 53 for Cardiac).  This change affects Part A outpatient therapy providers (billing on CMS 1450/UB04) including CORFs, […]

Continue Reading »

CMS Posts RAC “101” Informational Video on YouTube

April 13, 2010 0 Comments
CMS Posts RAC “101” Informational Video on YouTube

CMS has recently announced a new round of RAC informational sessions for providers.  The video features the slide show used in the original fall RAC informational sessions along with commentary by Commander Marie Casey.  This video production is one of many that have been posted by CMS/HHS on YouTube.  This video is being released as […]

Continue Reading »

Therapy Cap for 2009 Announced Transmittal R1851 (CR6660)

November 20, 2009 0 Comments
Therapy Cap for 2009 Announced Transmittal R1851 (CR6660)

CMS has announced the therapy cap for 2010 is $1860, representing a $20 increase over the 2009 therapy cap.  Transmittal R1851 to the Medicare Claims Processing Manual, dated 11/13/2009 and the accompanying MLN Article MM6660 provide information on the implementation.  The Balanced Budget Act of 1997 (BBA) established a $1500 therapy cap for physical therapy (including speech-language […]

Continue Reading »

Florida Rehab Providers Now Receiving RAC Demand Letters

November 10, 2009 1 Comment
Florida Rehab Providers Now Receiving RAC Demand Letters

Florida therapy providers are beginning to report the receipt of official “demand letters” from Connolly Healthcare, the Region C Recovery Audit Contractor.   A Florida therapy provider, who asked not to be identified, has reported receiving several demand letters related to the billing of speech therapy untimed codes in units greater than one.  This provider has multiple […]

Continue Reading »