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Tag: Rehab Agency

What is A Rehab Agency?

September 11, 2015 0 Comments
What is A Rehab Agency?

I get calls and inquiries asking “what is a rehab agency”.  Generally people have heard that a rehab agency may be a more profitable outpatient model than private practice, or that supervision rules for assistants are more favorable.  Some outpatient providers have been told by managed care payors that certification as a rehab agency or CORF […]

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Therapy Supervision

September 6, 2015 4 Comments
Therapy Supervision

Therapy supervision rules differ by venue in terms of Medicare, and may differ by state jurisdiction for Medicaid. Tricare does not have therapist supervision rules for private practice, as therapy assistants are not allowed by Tricare Military policy.  Medicare, Medicaid and Tricare supervision rules are payor rules.  There are also practice rules for supervision noted in your physical […]

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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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Rehab Agency Fire Standards

July 16, 2014 0 Comments
Rehab Agency Fire Standards

CMS has released updated interpretive guidelines specifically addressing rehab agency fire standards.  Rehab Agencies are also known as ORFs (Outpatient Rehabilitation Facilities) and are referred to as OPTs, (physical therapy) or OSTs (Speech Language Pathology) in various CMS guidelines.  Rehab Agencies are subject to Survey and Certification according to the Rehab Agency Conditions of Participation […]

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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 […]

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Physical Therapy Role in ACO – Presentation by Tim Richardson

September 6, 2011 0 Comments
Physical Therapy Role in ACO – Presentation by Tim Richardson

A a recent meeting of Florida Physical Therapists in Private Practice Tim Richardson presented on how physical therapists can drive practice and in particular their role in Accountable Care Organizations (ACO).   The FLPTPP is a new organization and this was their first meeting. This presentation, while over 100 slides is worth the view if you […]

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Webinar: Medicare Fraud and Abuse Initiatives Targeting Therapy Providers

August 18, 2011 0 Comments
Webinar: Medicare Fraud and Abuse Initiatives Targeting Therapy Providers

Join me for a webinar on August 23rd on increased Medicare fraud & abuse initiatives targeting therapy providers.  Lynn McGivern, Chief Compliance Officer at ATI Physical Therapy will join me as you hear about these new initiatives, why therapy providers are being targeting and how to mitigate the risk for your practice.  The webinar is […]

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CERT Errors Continue to Highlight Physical Therapy

August 18, 2011 0 Comments
CERT Errors Continue to Highlight Physical Therapy

The Comprehensive Error Rate Testing (CERT) Program continues to highlight errors in physical therapy billing as evidenced by the 2nd Quarter Report posted by Wisconsin Physician Services (WPS), the Legacy Part B provider in MInnesota, Illinois, Wisconsin and Michigan.  The most recent reports continues to highlight the fact that therapy minutes (as documented in the […]

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OIG Testimony Before the House Sub-Committees on Health & Oversight

June 15, 2010 0 Comments
OIG Testimony Before the House Sub-Committees on Health & Oversight

Lewis Morris, the Chief Counsel to the Office of the Inspector General (OIG) of HHS provided testimony this morning before the subcommittes on Health & Oversight of the U.S. House Ways and Means Committee.  The text of Mr. Morris’s message provides insight into successful fraud and abuse intitatives by the OIG as well as the success […]

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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, […]

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