CMS Proposes Payment Changes for Medicare Home Health Agencies for 2014 [06-28-13]

Filed under: Industry Updates — Editor @ 4:11 pm

cmsannouncementOn June 27, CMS announced proposed changes to the Medicare home health prospective payment system (“HH PPS”) for calendar year (“CY”) 2014. CMS projects that Medicare payments to home health agencies in CY 2014 will be reduced by 1.5%, or $290 million relative to CY 2013, based on the proposed policies. (more…)

MedPAC Submits June Report to Congress – Therapy Highlighted [06-22-13]

Filed under: Industry Updates — Editor @ 10:47 am

medpac-dataOn June 14, the Medicare Payment Advisory Commission (“MedPAC”) submitted its annual June report to Congress on Medicare and the Health Care Delivery System. The Commission estimated that Medicare payments to doctors will be cut by 24.4% on January 1, 2014 if Congress does not pass legislation to correct the Sustainable Growth Rate (“SGR”) formula (also known as “doc fix”) before the end of the year.  Other highlights of the report include the Mandated report: Improving Medicare’s payment system for outpatient therapy services. (more…)

CMS Provides Additional Clarification on Reporting Requirements for Functional Limitation Codes [06-21-13]

Filed under: Industry Updates — Editor @ 9:34 am

cmsannouncementThe Centers for Medicare and Medicaid Services (CMS) recently provided  additional clarification on the functional therapy reporting requirements effective for Part B therapy providers with dates of service on or after July 1, 2013. In our update from Tuesday, June 18th, CMS indicated “for beneficiaries whose treatment began prior to July 1, 2013 but for whom Functional Reporting information has not been submitted, the first claim submitted with a DOS on or after July 1, 2013 should be treated as the initial claim and include the required Functional Reporting.” CMS has provided the following additional clarification for these continuing claims of service: the July claim does not need to include an evaluation or re-evaluation code to begin transmitting the functional limitation codes. The first appointment would be considered a 10 day progress note coded with the G-codes and their related modifiers. This visit will then start the count towards their next progress reporting date. (more…)

Functional Code Reporting Update from CMS [06-18-13]

Filed under: Industry Updates — Editor @ 3:18 pm

cmsannouncementCMS has provided the below update based on the June 4th Open Door Forum statement that, “on July 1st functional reporting will start which requests doing initial evals, goals & status. The July 1st treatment has to be treated as the initial eval, even if [provider] have been treating the patient. [CMS] realizes it is ‘a little bit of a burden’ but feel it is necessary.” (more…)

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