tci Medicare Compliance & Reimbursement - 2006 Issue 15

THERAPY: HHAs Should Hold Off On Expedited Determination Notices For Part B Therapy

They can't reach for HHABNs either.Home health providers can avoid unnecessary extra work if they furnish outpatient therapy to patients in the home--but they must heed new guidance from the feds.Patients who exceed the new $1,740 annual cap for either occupational therapy or physical therapy and speech therapy combined aren't eligible for the expedited determination process, the Centers for Medicare & Medicaid Services explains in new questions-and-answer postings. The cap applies only to Part B therapy, not therapy under the home health benefit."Exceeding the therapy cap does not trigger the expedited right," CMS explains...

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