Tag: outpatient therapy

Adverse events occur during SNF stays

A recent study published by the Office of the Inspector General (OIG) found that over 20% of Medicare beneficiaries experience adverse events during their SNF stay. The study also found that an additional 11% experience temporary harm events during their SNF stay. The study estimated the national incidence rate, preventability, and cost of adverse events […]

Patients obtain opioid prescriptions from multiple healthcare providers

One in three American seniors who benefit from the U.S. Medicare program, receives painkiller prescription from several healthcare service providers, according to a study released by the British Medical Journal. This practice places seniors at risk for drug overdose, injury, and even death. Researchers analyzed the medical records of more than one million Medicare patients […]

GAO releases report on implementation of Manual Medical Review process

On July 10, the United States Government Accountability Office (GAO) released a report to Congress about the implementation of the 2012 manual medical review (MMR) for Medicare outpatient therapy. According to the report, in 2011, Medicare paid about $5.7 billion to provide outpatient therapy services for 48 million beneficiaries. This report describes the Center for […]

Outpatient Therapy Functional Reporting: Ensure You are in Compliance

CMS has implemented a new claims-based data collection system for outpatient therapy services by requiring reporting of functional limitations with 42 new nonpayable G-codes and 7 new modifiers on specified claims for physical therapy (PT), occupational therapy (OT) and speech-language pathology (SLP) services. The claims-based data collection system is effective for outpatient therapy services with […]

President Obama Signs the American Taxpayer Relief Act of 2012

On January 2, President Obama signed into law the American Taxpayer Relief Act of 2012. This law prevents a schedule payment cut for physicians and other practitioners who treat Medicare patients from taking effect on January 1, 2013, among other things. Concerning MDS-related items, this bill extends therapy caps through January 31, 2013: $1,900 for […]