Part B Insider (Multispecialty) Coding Alert

Published on Tue Jan 01, 2008 PDF

When President Bush submits his 2009 budget on Monday, he-ll propose -large cuts- in the Medicare program, according to a Jan. 31 New York Times article.

Although many pundits speculated that the president would announce Medicare cuts during his State of the Union address Jan. 28, he largely glossed over the issue. On the other hand, -budget documents show that Mr. Bush will propose legislative changes in Medicare to save $6 billion in the next year and $91 billion from 2009 to 2013,- mainly through cuts to hospitals, nursing homes, hospices, ambulances and home care, the Times says.

Continue reading future issues of the Insider for updates on how the budget negotiations shake out on Capitol Hill.
 
In Other News -

- OIG Wants to Hear From You on Compliance Program Guidance for Nursing Facilities

The OIG is revising its compliance program guidance (CPG) for nursing facilities, and it wants your input.

According to the Jan. 24, 2008, Federal Register, the nursing home industry has changed dramatically since the OIG published its first CPG for it in 2000, and the OIG also wants to address risk areas in the new CPG that it has discovered through its compliance activities over the past eight years.

To let the OIG know your comments on the CPG, submit your feedback by Feb. 25 either electronically (at www.regulations.gov), or by U.S. mail. Visit http://oig.hhs.gov/authorities/docs/08/CPG_Nursing_Facility_Solicitation.pdf for more information on the OIG's efforts.
 
- Get to Know Therapy Cap Amounts

Congress placed a moratorium on Medicare's 2008 therapy cap until June 30, but that doesn't mean you should avoid learning about this year's cap features.

Effective July 1 (when the moratorium expires), occupational therapy services will be subject to a $1,810 Medicare limit, while combined physical therapy and speech-language pathology reimbursement will face a separate $1,810 cap.

Therefore, if your physical therapist treats a patient on July 10 and you bill $800, and a speech-language pathologist treats the patient on Aug. 1 and bills $600, the patient will only be allowed another $410 in PT/SLP benefits for the remainder of 2008, but the patient would still have $1,810 in Medicare reimbursement available for occupational therapy services.

Exception: In some cases, the therapist may administer services that aren't subject to the Medicare payment cap because they are included on the therapy cap -exceptions- list. For these procedures, Medicare will automatically process the claims without counting the payments toward the cap.

To read more about the therapy cap, visit CMS- MLN Matters site at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5871.pdf.