Tag: therapy

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. […]

SNF PPS final rule published, new payment model to begin October 1, 2019

It’s official: According to CMS’ Skilled Nursing Facility (SNF) Prospective Payment System (PPS) final rule published in the Federal Register yesterday evening, the Patient-Driven Payment Model (PDPM)—the new case-mix methodology to replace RUG-IV)—is effective October 1, 2018. Facilities will have a year to transition to PDPM from RUG-IV by the October 1, 2019 implementation date. […]

Virtual, interactive training to increase interdepartmental collaboration

If collaboration isn’t on the tip of your staff’s tongue, it should be. On Wednesday, April 11, 12-3pm, ET, industry experts and seasoned long-term care providers Liz Barlow, BSN, RN, CRRN, RAC-CT, DNS-CT and Renee Kinder, MS, CCC-SLP, RAC-C invite your nursing and therapy staff to participate in a virtual, interactive training workshop that will […]

Overcome common hurdles and improve interdepartmental collaboration

If Collaboration isn’t on the tip of your staff’s tongue, it should be. On Wednesday, April 11, 12-3pm, ET, industry experts and seasoned long-term care providers Liz Barlow, BSN, RN, CRRN, RAC-CT, DNS-CT and Renee Kinder, MS, CCC-SLP, RAC-C invite your nursing and therapy staff to participate in a virtual, interactive training workshop that will […]

RCS-1 draft model calculation worksheet

SNF providers are on the edge of their seats as they anticipate CMS’ consideration of a replacement for the Resource Utilization Group (RUG) system, which will change the way facilities are reimbursed for SNF Medicare Part A residents beginning as early as FY2019. The Resident Classification System, Version 1 (RCS-1) will be the most significant […]

New CMS policy could change inpatient rehab denial trend

In the past, Medicare contractors have been allowed to deny a claim for inpatient rehab if the required three-hour minimum of direct care mark was missed by mere minutes, even if the additional minutes were made up on a subsequent day. Now, however, due to new guidance released by CMS, this denial trend could change. […]

Who needs to prepare for RCS-1?

On July 31, 2016, CMS announced that the payment levels currently used in the prospective payment system (PPS), resource utilization group (RUG) IV, will be replaced in FY2019 by the resident classification system (RCS-1). This replacement is currently scheduled to be implemented by October 2018. This will be a complicated and significant change for providers. […]

Two-year budget deal repeals therapy caps, cuts skilled nursing spending by $1.96 billion

Last week, President Donald Trump signed a two-year federal budget deal that left long-term care providers sighing with relief at the repeal of therapy caps for Medicare Part B beneficiaries retroactive to January 1, followed by a sigh of disappointment with a $1.96 billion cut to skilled nursing facility (SNF) spending. The cuts include a payment […]

CMS recommends billing staff become aware of updates to “Always Therapy” code edits

The Centers for Medicare & Medicaid Services (CMS) recently published an update that deleted the procedure code 97532 from the list of “Always Therapy” codes used to track the Medicare Part B therapy caps. The coding requirement change is effective for services furnished on or after January 1, 2018. CMS notes that this update contains […]

The transition to a unified payment system for PAC facilities could start as early as 2019, suggests MedPAC

In response to a Congressional mandate, in 2016 The Medicare Payment Advisory Commission (MedPAC) recommended design features of a unified payment system, the post-acute-care (PAC) prospective payment system (PPS), to pay for services in the four post-acute care settings (home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals). In a meeting […]