Physical therapists who submit Medicare Part B claims without proper functional limitation data, for services provided on or after January 1, 2013, soon will get feedback from the Centers for Medicare and Medicaid Services (CMS) reminding them of the new functional limitation reporting requirements. For claims processed April 1 through June 30, 2013, CMS will send Remittance Advice messages to providers whose claims lack the required data, alerting them to include the applicable G-codes and appropriate severity/complexity modifier on future specified claims.
Providers who bill certain CPT evaluation/reevaluation codes (the affected codes are: 92506, 92597, 92607, 92608, 92610, 92611, 92612, 92614, 92616, 96105, 96125, 97001, 97002, 97003, and 97004) and fail to submit functional limitation data will receive a remittance advice code of N566. Providers who bill the affected CPT codes and submit functional limitation codes (G8978-G8999, G9158-G9176, and G9186) without a severity modifier (CH-CN) will receive a remittance advice code of N565.
CMS published this information in transmittal RT1196OTN and in a Medicare Learning Network article.
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, 2013, all practice settings that provide outpatient therapy services must include the functional limitation data on the claim form. To ensure a smooth transition, CMS set forth a testing period January 1 to July 1. After July 1, claims submitted without the appropriate G-codes and modifiers will be returned unpaid.
APTA has additional details and resources on these new requirements under its Medicare webpage.
In recognition of World Down Syndrome Day, today MoveForwardPT.com, APTA's official consumer information website, hosted an online radio show about the role of physical therapy in the development of people with Down syndrome.
In the episode, which was a Blog Talk Radio "Staff Pick" for March 21, APTA member Venita Lovelace-Chandler, PT, PhD, PCS, discusses how physical therapists help children with Down syndrome develop gross motor skills to achieve important physical developmental milestones that also benefit the child's social and cognitive maturation. She also provides tips for parents.
APTA issued a press release about the show and also promoted MoveForwardPT.com's Physical Therapist's Guide to Down Syndrome via social media.
Move Forward Radio airs approximately twice a month. Episodes are featured and archived at MoveForwardPT.com and can be streamed online via Blog Talk Radio or downloaded as a podcast via iTunes.
Previous episodes have covered conditions ranging from concussion to osteoporosis and explored settings ranging from aquatic physical therapy to physical therapy in the performing arts.
APTA members are encouraged to alert their patients to this series and other MoveForwardPT.com resources to help educate the public about the benefits of treatment by a physical therapist. Ideas for future episodes and other feedback can be e-mailed to email@example.com.
Attend APTA's first-ever online Virtual Career Fair on Tuesday, April 9, 1:00 pm-4:00 pm, ET. This live, online event is a great way for you to engage directly with employers about their current and future physical therapy opportunities.
Participate in the Virtual Career Fair for as long as you wish, chatting 1-on-1 with recruiters to discuss your background and experience, and their current and future career opportunities.
Space is limited, so register now.
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