tci Part B Insider - 2015 Issue 43

Face-to-face Physician Certs: Expect 'Probe & Educate' Claims Reviews for Face-to-Face Rules

CMS finally sheds light on audit program. The other shoe is finally dropping on the new face-to-face documentation requirements that took effect back in January. In early summer, CMS announced a “Probe & Educate” (P&E) medical review push focused on face-to-face physician encounter compliance, but provided few specifics. Now CMS is offering more details in a MLN Matters article it released on Nov. 9. The P&E initiative aims “to assess and promote provider understanding and compliance with the Medicare home health eligibility requirements,” CMS says in MLN Matters No. SE1524. Specifically, CMS highlights the...

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