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  • Updated FLR Guidelines Address Reporting on Additional Evaluative Procedures

    The Centers for Medicare and Medicaid Services (CMS) updated its guidance on functional limitation reporting (FLR) around reporting evaluative procedures that are for different limitations in addition to those currently being reported.

    The new guidance is included in the Frequently Asked Questions document (.pdf) on the CMS Therapy Services website and provides instructions on how to report these additional procedures and functional limitations while continuing to report on the primary limitations. CMS provides the following answer:

    "You should report the evaluative procedure furnished for a second/different functional limitation other than the primary functional limitation for which ongoing reporting is occurring as a one-time visit (i.e., report all three G-codes in the code set for the functional limitation that most closely matches that for which the evaluative procedure was furnished). The ongoing reporting of a primary functional limitation is not affected when all three G-codes in a code set are reported for the evaluative procedure furnished for a second functional limitation. Note: The reporting of all three G-codes for the evaluative procedure for a second functional limitation and the ongoing reporting of a primary functional limitation can both occur on the same date of service."

    APTA has updated its functional limitation reporting webpage to reflect the new information and will create a podcast about the update during the week of November 4.


    • Good information however referred to PTA as "therapy" assistant instead of therapist assistant.

      Posted by Angie Hoerner, PTA on 11/5/2013 12:36 PM

    • I am confused...is CMS stating that were are supposed to report 3 G-codes when we receive a new script and eval a different body part during a patients current episode of care?

      Posted by anamarie on 11/6/2013 8:40 AM

    • This is confusing.

      Posted by David Bullock on 11/13/2013 10:54 AM

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