tci Part B Insider - 2012 Issue 32

Physician Note: CMS Reconfirms MACs Will Manually Approve Therapy Services Over $3,700 Threshold

Plus: Hospices must keep promises, one MAC says.CMS has finally revealed details about the manual medical review process for outpatient therapy dollar amounts exceeding $3,700 with the release of MLN Matters article MM8036, effective Oct. 1Background: Last February, the Middle Class Tax Relief and Job Creation Act of 2012 (H.R. 3630) saved the therapy cap exceptions process by a hair -- but not without a catch. Effective Oct. 1, 2012, after a patient hits $3,700 in exceptions, further therapy payments will be subject to manual medical review.How it works: The first level to therapy...

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