Eli's Rehab Report

The Centers for Medicare and Medicaid Services (CMS) released its final rule for services reimbursed under the Medicare Physician fee schedule on Oct. 30. Of note, the agency set the therapy cap dollar amount for 2010 to $1,860 for occupational therapy and $1,860 for physical therapy and speech-language pathology services combined.

Visit the following link, and go to page 1021 to read therapy cap information: www.federalregister.gov/OFRUpload/OFRData/2009-26502_PI.pdf.

Plus: Separately, CMS discusses Canalith Repositioning -- CPT code 95992 (Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day) -- which was a new code the American Medical Association created for 2009. CMS has decided to make that code not valid for Medicare purposes.

The good news, however, is that therapists who perform this type of vestibular rehab procedure can still get paid. The rule instructs therapists who perform Canalith Repositioning (Epply and Semont maneuver) to bill for that time under neuromuscular re-education -- CPT code 97112 (...Neuromascular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and or standing activities). This discussion begins on page 154 of the rule. The Final Rule will appear in the Federal Register on November 25, 2009.