Yesterday, officials from the Centers for Medicare and Medicaid Services (CMS) held a call with therapy stakeholder groups to describe their plans to implement the manual medical review process for the therapy cap exceptions that exceed $3,700 effective October 1. CMS has provided a fact sheet and question-and-answer document regarding the process and will issue a transmittal in the coming days. The therapy cap is an annual per-beneficiary limitation on services that applies to all outpatient therapy settings except critical-access hospitals.
Highlights regarding manual medical review include these:
A special open door forum (ODF) teleconference on the manual medical review of therapy claims will be held August 7, 2 pm-3:30 pm, ET. Special open door participation instructions are below: