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  • CMS Further Clarifies Functional Limitation Reporting Requirements

    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.