tci Medicare Compliance & Reimbursement - 2003 Issue 19

PROGRAM MEMO ROUNDUP

Brace yourself, rehab providers. The Centers for Medicare & Medicaid Services is gearing up to implement the much dreaded - and oft delayed - therapy cap. In a May 2 program memorandum (AB-03-057; http://cms.hhs.gov/manuals/pm_trans/AB03057.pdf), CMS declares that Medicare claims processors should begin applying the cap starting July 1. The cap applies to occupational therapy and physical therapy (including speech-language pathology). In other recent program memoranda, CMS: lists diagnosis codes for pap smear and pelvic exam services (AB-03-054; http://cms.hhs.gov/manuals/pm_trans/AB03054.pdf); declares that therapy services rendered by physicians are excluded from home health consolidated billing (B-03-037...

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