tci Medicare Compliance & Reimbursement - 2003 Issue 19

Therapy: DOC-FURNISHED THERAPY NOT HHAS' RESPONSIBILITY

Starting this fall, physicians won't be knocking on home health agencies' doors asking for therapy payment. Outpatient therapy services are bundled into home health consolidated billing under the prospective payment system, but not if it is a physician rather than a therapist who furnishes the PT, the Centers for Medicare & Medicaid Services clarifies in May 2 program memorandum B-03-037. The claims processing system currently doesn't differentiate between doc- and therapist-furnished PT and is denying therapy payment for physicians when the patient is under a home health plan of care. Contractors will fix the problem by Oct. 1, CMS...

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