tci Medicare Compliance & Reimbursement - 2003 Issue 8

PROGRAM MEMO ROUNDUP

The Centers for Medicare & Medicaid Services Feb. 14 updated payment rules for certain services provided by outpatient physical therapy providers under the Medicare physician fee schedule. In addition to listing outpatient rehabilitation HCPCS codes, program memo A-03-011 (http://cms.hhs.gov/manuals/pm_trans/A03011.pdf) also lays out new payment requirements for fiscal intermediaries — including a mandate that FIs shouldn’t pay for drugs and biologicals in an OPT setting and that OPTs shouldn’t bill separately for supplies they furnish. In other recent program memoranda, CMS: • sets out policies relating to additional documentation requests issued to providers that order...

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