The Centers for Medicare and Medicaid Services (CMS) has issued revised portions of the Medicare Benefits Policy and Claims Processing manuals to clarify coverage of skilled therapy services in maintenance care. The revisions were mandated as a result of the Jimmo v Sibelius settlement agreement reached in US District Court earlier this year.
In the transmittal (.pdf), CMS reiterates its longstanding policy that skilled therapy services still may be covered even in situations where no improvement is possible, including when skilled services are needed to prevent deterioration. The transmittal also contains information on the documentation necessary for coverage determinations in skilled maintenance therapy.
APTA is reviewing the transmittal and will provide a detailed summary in the coming days.
Join CMS from 2:00 pm to 3:00 pm December 19 for a Medicare Learning Network conference call on how the Jimmo v Sibelius agreement will affect the services provided by physical therapists. Registration is open now, but spaces are likely to fill up quickly.
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