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  • NY, CT Medicare Contractor Makes Official Announcement of Documentation Rule Changes

    Physical therapists (PTs) in New York and Connecticut have received official word that 2 burdensome requirements have been lifted. The changes reduce reporting and documentation rules that were in conflict with national Medicare policy.

    National Government Services, the Medicare administrative contractor (MAC) for the 2 states, released a statement on October 24 announcing that PTs are no longer required to submit progress reports every 5 days after services exceeded the therapy cap, and that requirements for documentation of a physician reexamination for services that exceeded either 90 days or the therapy cap have been removed. The changes are effective for dates of service on or after August 1, 2013.

    APTA and chapters in New York and Connecticut advocated for changes to the NGS requirements, which directly conflicted with national Medicare policy. NGS posted detailed information about the changes to Outpatient Physical and Occupational Therapy Services (L26884) Local Coverage Determination (LCD) on its website.


    • Is that also applicable for patients under Medicare part B in Skilled Nursing Facilities?

      Posted by Honeylet Ibia on 10/30/2013 7:11 AM

    • To Honeylet Ibia, Yes this LCD applies to Part B services for residents of SNF's.

      Posted by Cathy Anastasio on 11/1/2013 5:05 PM

    • Does anyone know if the HMO's are required to state the reason for their denial of Physical Therapy services for Med A patients during short term rehab in a SNF ? Thank you.

      Posted by Kathy Henning on 5/2/2014 10:56 AM

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