The Centers for Medicare and Medicaid
Services (CMS) yesterday further clarified the regulations on the new
functional limitation reporting requirements to include reporting on patients
who have Medicare part B as a primary insurance and those who have Medicare
part B as a secondary insurance.
CMS was mandated to collect information on
claim forms regarding beneficiaries' function and condition, therapy services
furnished, and outcomes achieved on patient function by the Middle Class Tax
Relief Act of 2012. As of January 1, all practice settings that provide
outpatient therapy services must include the functional limitation data on the
claim form. To ensure a smooth transition, CMS sets forth a testing period
January 1-July 1. After July 1, claims submitted without the appropriate
G-codes and modifiers will be returned unpaid. For additional details and
resources on these new requirements, see the FAQ under General Information on APTA's
Functional Limitation Reporting Under Medicare webpage.