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  • Inconsistent and Burdensome Documentation Rules Removed From NY, CT LCD Policy

    New York and Connecticut physical therapists no longer have to follow certain burdensome documentation requirements that were in conflict with national Medicare policy.

    Thanks to efforts by APTA and the New York and Connecticut chapters, the Medicare administrative contractor (MAC) for those states removed 2 requirements from its local coverage determination policy: (1) for progress reports to jump from a frequency of every 10 treatment days to every 5 treatment days after services exceeded the therapy cap, and (2) for documentation of a physician reexamination for services that exceeded either 90 days or the therapy cap. Both requirements directly conflicted with national Medicare policy.

    APTA sent a letter on May 6 to the MAC, National Government Services Inc (NGS), expressing concerns about the documentation requirements and urging NGS to make them consistent with national Medicare policy. In response, NGS is removing these requirements in a revised policy that is effective for dates of service on or after August 1, 2013.

    For questions or more information, please e-mail advocacy@apta.org.


    • Is this saying that the progress reports are now at a frequency of every 10 treatment days not 5 treatment days? What is the therapy cap and how many treatment days is the therapy cap?

      Posted by Dara on 9/25/2013 9:04 AM

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