Tag: Medicare reimbursement

Therapist layoffs reported as a result of PDPM

Since the implementation of PDPM on October 1, thousands of therapists have been laid off, reports Modern Healthcare. The payment system prior to PDPM, RUG-IV, allowed SNFs to bill therapy services they deemed necessary, but some took advantage by ordering superfluous therapy services to gain additional reimbursement from Medicare. PDPM seeks to stop this practice. […]

Evidence-based criteria for determining whether services are skilled

Editorial Note: This post is an excerpt from HCPro’s title Long-Term Care Skilled Services: How to Document for Proper Medicare Reimbursement by Elizabeth McLaren. Chapter 8 of the Medicare Benefit Policy Manual, Section 30.2.2 (“Principles for Determining Whether a Service is Skilled”) starts to look more closely at the criteria for assessing a skilled need. […]