On Monday, the Centers for Medicare and Medicaid Services (CMS) will release a follow-up Comparative Billing Report (CBR) to the 5,000 independent physical therapy providers who received the report in 2010. The CBR shows KX modifier use for 5 codes commonly billed by physical therapists. The report will be the same format as the CBR released in 2010. However, this CBR will use 2011 billing data, intending to inform providers of any change in use since receiving the original CBR.
The CBRs are produced by Safeguard Services under contract with CMS and contain data-driven tables and graphs with an explanation of findings that compare nationally and statewide physical therapist billing and payment patterns with the KX modifier. Safeguard Services has indicated to APTA that these reports are only educational rather than punitive, intending to prevent improper billing and use of the KX modifier.
For more information regarding these Outpatient Physical Therapy Services CBRs, visit CBR Services' website or call the SafeGuard Services' provider help desk, CBR support team, at 530/896-7080.
The Centers for Medicare and Medicaid Services' (CMS) 3-year Medicare Prior Authorization for Power Mobility Device (PMD) demonstration begins September 1. The demonstration is designed to develop and demonstrate improved methods for the investigation and prosecution of fraud in the provision of care or services. CMS believes this demonstration will lead to reductions in improper payments for power mobility devices.
CMS will implement a prior authorization process for scooters and power wheelchairs for people with fee-for-service Medicare who reside in 7 states with high populations of fraud- and error-prone providers (California, Illinois Michigan, New York, North Carolina, Florida, and Texas). Additionally, this demonstration will help ensure that a beneficiary's medical condition warrants his or her medical equipment under existing coverage guidelines and assist in preserving a Medicare beneficiary's ability to receive quality products from accredited suppliers.
Based on comments from APTA and other stakeholders, CMS removed the 100% prepayment review phase (formerly Phase 1) from the demonstration earlier this year. Also based on stakeholder feedback, CMS will allow suppliers to perform the administrative function of submitting the prior authorization request on behalf of the physician/treating practitioner.
Additional information is available on CMS' website.
This month's PTJ has a diversity of authorship—with articles by physical therapists, occupational therapists, engineers, basic scientists, and physicians from around the world. Hear Editor in Chief Rebecca Craik, PT, PhD, FAPTA, summarize the issue's 6 research reports and 2 "remarkably interesting" case reports and offer her comments on articles' contribution to the literature in the in the August Craikcast.
Plan now to make this your best National Physical Therapy Month (NPTM) event yet. Go to www.apta.org/NPTM for this year's tools and resources. Start with the 2012 NPTM Event Planning Guide for specific information about conducting a successful community event. Next, check out the links to tools and resources designed specifically for this year's celebration, such as a sample proclamation for your governor or mayor, sample press release, logos, and web buttons. New tools will be added in the coming weeks, such as an event flyer template and downloadable NPTM bookmarks to give to patients and members of your community. And, learn how you can participate in APTA's public relations initiative, "Fit After 50," kicking off during NPTM.